Long-term outcome after all inside meniscal repair using the FasT-Fix system

Zimmerer, Alexander; Sobau, Christian; Nietschke, R.; Schneider, M. M.; Ellermann, Andree

doi:10.1016/j.jor.2018.05.042

Cited by 28 publications

(41 citation statements)

References 28 publications

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“…The overall failure rate of 22.5% is consistent with previous reports. 3,14,16,17,19,26,38 Lateral Repair Lateral repairs resulted in less failure than medial repairs that have nearly a 4 times higher risk of failure. This is supported by data from a recent systematic review, 27 which concluded that lateral repairs result in fewer reoperations than medial repairs.…”

Section: Meniscal Suturesmentioning

confidence: 99%

Predictive Factors for Failure of Meniscal Repair: A Retrospective Dual-Center Analysis of 918 Consecutive Cases

Rönnblad

Barenius

Engström

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Meniscal surgery is one of the most common surgical procedures performed by orthopaedic surgeons. Over the past decade, awareness has increased regarding the importance of meniscal preservation to prevent the development of osteoarthritis in the knee joint. Removal of meniscal tissue can lead to a high risk of cartilage degeneration, and moreover, meniscus-preserving surgery rather than meniscal resection is likely to have better long-term outcomes. Success rates after meniscal repair range from 60% to 95%, but many reports are based on a small number of patients.Purpose/Hypothesis: The purpose of this study was to review all meniscal repairs and potential predictors for failure during a 12year period. We hypothesized that meniscal anchors, lateral repairs, and repairs made in conjunction with an anterior cruciate ligament reconstruction (ACLR) would have fewer failures than meniscal arrows, medial repairs, and isolated repairs. We also hypothesized that younger patients and acute tears would be associated with fewer failures.Study Design: Case-control study; Level of evidence, 3.Methods: This study was a dual-center, retrospective analysis on consecutive meniscal repairs. The surgical protocols were reviewed, including type of tear, location, associated injury to the knee, and surgery. The study endpoint was failure of repair, defined as a need for reoperation and secondary partial or total meniscal resection, within 3 years. Kaplan-Meier analysis was performed to assess repair survival, with multivariate Cox regression to adjust for confounders.Results: A total of 954 meniscal repairs were performed on 918 patients (536 male patients [58%]; 382 female patients [42%]) with a mean age of 26 years (range, 12-60 years). The failure rate for the entire cohort was 22.5%. Bioabsorbable arrows had significantly more failures than all-inside sutures with anchors (hazard ratio [HR], 1.8; 95% CI, 1.2-2.5; P ¼ .002). Medial meniscal repairs had a higher failure rate than lateral meniscal repairs (HR, 3.7; 95% CI, 2.3-6.0; P < .001). Simultaneous ACLR resulted in less failure than when no simultaneous ACLR was performed (HR, 0.5; 95% CI, 0.3-0.9; P ¼ .009). Age at repair and acuity of tear did not affect the outcome (P ¼ .6 and .07, respectively). Conclusion:The failure rate after meniscal repair was significantly higher on the medial side, especially when using arrows. Meniscal repairs performed concomitantly with an ACLR result in fewer reoperations.

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Section: Meniscal Suturesmentioning

confidence: 99%

Predictive Factors for Failure of Meniscal Repair: A Retrospective Dual-Center Analysis of 918 Consecutive Cases

Rönnblad

Barenius

Engström

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…In this study there was a gender difference in failure rate with a higher failure rate in males, however the cause of this is unclear. This differs to the results of Zimmerer [12]. In their long term outcome study using the Fast-Fix ™ system they noted a statistically higher failure rate for women than men (40 failures in women 23 failures in men) where failure was de ned as a new operation on the same meniscus.…”

Section: Discussionmentioning

confidence: 67%

“…The mechanism of injury may re ect the quality of the meniscus and its ability to hold the meniscal suture device. Zimmerer [12] found a correlation between soccer and indoor sports as a mechanism of injury and subsequent long term failure of meniscal repair with the Fast-x system.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Mode of Deployment Failure of the Fast-Fix 360™ Meniscal Repair Device

Lawrie¹,

Lawrie

Vertullo

2020

Preprint

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Background Meniscal repair device deployment failure is a recognised complication of all-inside meniscal repair with subsequent risk of patient harm. The Fast-Fix device has undergone design changes to reduce deployment failure since its introduction in 2001. Purpose The purpose of this study was to assess the incidence and mechanism of intra-operative deployment failure of the 3 rd generation Fast-fix 360™ (Smith & Nephew, Andover, USA) device. Method Data was prospectively collected for 106 consecutive all-inside meniscal repairs undertaken with the Fast-fix 360™ device. Patient demographics, mechanism of failure, site and type of repair were recorded. Results 20 deployment failures occurred in 423 Fast-fix 360™ deployments, an incidence of 4.72%. Deployment failure occurred in 19 of 109 patients an incidence of 17.43%. Six different failure mechanisms occurred; anchor exiting device without trigger being initiated, anchors not holding in meniscus, both anchors simultaneously exiting device and braided suture failing. The most common failure mechanism was failure of the second anchor not holding in the meniscus. Average cost of device failure was $75 per patient. Conclusion Despite design modification, deployment failure still occurs with similar modes top to the original design.

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“…Of the 11 studies, only one demonstrated a significant difference in meniscus repair failure risk by sex. Zimmerer et al found a higher failure risk in females, with 11 of 23 (48%) females noted to have failed meniscus repairs versus 6 out of 40 (15%) males with failed repairs (p=0.0076) 24. Given the different findings and relatively low follow-up (less than 20%) in this study, the meta-analysis of clinical signs of repair failure was repeated with this study excluded and again no difference in failure risk was noted between male and females (OR 1.20, 95% CI 0.76 to 1.89, p=0.43).…”

Section: Resultsmentioning

confidence: 98%

Meniscus repair failure risk does not differ by sex: a systematic review

et al. 2020

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Long-term outcome after all inside meniscal repair using the FasT-Fix system

Abstract: At 12 years' follow-up 73% had a successful surgery. KOOS was significantly better within isolated meniscus tears. Both groups showed no difference in the TAS. There were no differences regarding failure rate in the comparison of simultaneous or delayed ACL-reconstruction.

Cited by 28 publications

References 28 publications

Predictive Factors for Failure of Meniscal Repair: A Retrospective Dual-Center Analysis of 918 Consecutive Cases

Predictive Factors for Failure of Meniscal Repair: A Retrospective Dual-Center Analysis of 918 Consecutive Cases

Incidence and Mode of Deployment Failure of the Fast-Fix 360™ Meniscal Repair Device

Meniscus repair failure risk does not differ by sex: a systematic review

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