Long-term outcome after meniscal repair

Tengrootenhuysen, Mike; Meermans, Geert; Pittoors, Kathleen; Riet, Roger van; Victor, Jan

doi:10.1007/s00167-010-1286-y

Cited by 107 publications

(93 citation statements)

References 41 publications

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“…The present study found a protective effect of repair against osteoarthritis, in agreement with the literature: long-term cartilage degradation rates range from 8% to 43% after repair, versus 21% to 64% after meniscectomy [8,10,20,23,24,[28][29][30][31]33,35,36]: i.e., a factor of 2. Table 2 Correlation between functional and quantitative radiological scores, both groups taken together.…”

Section: Discussionsupporting

confidence: 92%

“…There are numerous reports of results in meniscectomy [2][3][4][5][6][7][8]10,[22][23][24] and meniscal repair [25][26][27][28][29], comparisons between the two [20,30,31] and meta-analyses [32][33][34]. Interpretation, however, is hindered by numerous biases: meniscal surgery was either isolated or associated to anterior cruciate ligament surgery; patient ages and clinical and radiological assessment scoring systems differed; follow-up was short or variable; and initial meniscal lesion type, repair technique, meniscectomy extent and initial chondral status were not always specified.…”

Section: Discussionmentioning

confidence: 99%

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Meniscectomy versus meniscal repair: 10years radiological and clinical results in vertical lesions in stable knee

Lutz¹,

Dalmay

Ehkirch³

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

116

105

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Meniscectomy versus meniscal repair: 10years radiological and clinical results in vertical lesions in stable knee

Lutz¹,

Dalmay

Ehkirch³

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

116

105

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“…A missed unstable meniscus, combined with knee instability, will destroy the meniscal tissue and consequently end in surgical removal [51,52]. In the current series, we performed an immediate meniscal suture combined with DIS in 98 patients (36%), thereby creating an ideal environment for meniscal healing.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Intraligamentary Stabilization (DIS) for treatment of acute anterior cruciate ligament ruptures: case series experience of the first three years

Henle

Röder

Perler

et al. 2015

BMC Musculoskelet Disord

161

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BackgroundIn recent years, the scientific discussion has focused on new strategies to enable a torn anterior cruciate ligament (ACL) to heal into mechanically stable scar tissue. Dynamic intraligamentary stabilization (DIS) was first performed in a pilot study of 10 patients. The purpose of the current study was to evaluate whether DIS would lead to similarly sufficient stability and good clinical function in a larger case series.MethodsAcute ACL ruptures were treated by using an internal stabilizer, combined with anatomical repositioning of torn bundles and microfracturing to promote self-healing. Clinical assessment (Tegner, Lysholm, IKDC, and visual analogue scale [VAS] for patient satisfaction scores) and assessment of knee laxity was performed at 3, 6, 12, and 24 months. A one-sample design with a non-inferiority margin was chosen to compare the preoperative and postoperative IKDS and Lysholm scores.Results278 patients with a 6:4 male to female ratio were included. Average patient age was 31 years. Preoperative mean IKDC, Lysholm, and Tegner scores were 98.8, 99.3, and 5.1 points, respectively. The mean anteroposterior (AP) translation difference from the healthy contralateral knee was 4.7 mm preoperatively. After DIS treatment, the mean 12-month IKDC, Lysholm, and Tegner scores were 93.6, 96.2, and 4.9 points, respectively, and the mean AP translation difference was 2.3 mm. All these outcomes were significantly non-inferior to the preoperative or healthy contralateral values (p < 0.0001). Mean patient satisfaction was 8.8 (VAS 0–10). Eight ACL reruptures occurred and 3 patients reported insufficient subjective stability of the knee at the end of the study period.ConclusionsAnatomical repositioning, along with DIS and microfracturing, leads to clinically stable healing of the torn ACL in the large majority of patients. Most patients exhibited almost normal knee function, reported excellent satisfaction, and were able to return to their previous levels of sporting activity. Moreover, this strategy resulted in stable healing of all sutured menisci, which could lower the rate of osteoarthritic changes in future. The present findings support the discussion of a new paradigm in ACL treatment based on preservation and self-healing of the torn ligament.

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“…Better results are obtained in recent injuries. Tengrootenhuysen et al 85 obtained better results in meniscal repairs performed within 6 weeks of injury (83%) than late repairs (52%), as meniscal tears tend to become deformated over time 79,86,87 . Worse outcomes have been observed in young patients, perhaps because they take less care in the postope-@ C I C E d i z i o n i I n t e r n a z i o n a l i rative period, and in elderly patients, where the meniscus had already degenerated 88,89 .…”

Section: Clinical Results Of Meniscal Suturementioning

confidence: 99%

Meniscus tear surgery and meniscus replacement

Vaquero

Forriol

2016

MLTJ

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SummaryObjective: the menisci are easily injured and difficult to repair. The aim of this study was to analyze the current state of meniscal surgery aimed at preserving morphology and conserving the biomechanics of the knee to prevent joint degeneration. Methodology: a search of the electronic medical literature database Medline was conducted, from http://www.ncbi.nlm.nih.gov/pubmed. The search was not limited by language. Candidate articles were identified by searching for those that included the keywords meniscus, surgery, suture, implant, allograft. The limits were included for clinical research and clinical trials. Basic research was not included. The studies selected were evaluated and classified in three different categories: basic science, reconstruction (suture and meniscectomy) and implants (scaffolds and allograft). Results: the consequences of meniscectomy performed at a young age can lead to a joint cartilage degeneration twenty years later. There are few surgical options for the repair of meniscal injuries in order both to preserve the meniscus and to ensure the long term survival of the knee joint, meniscectomy, repair, suturing the tear, or reconstruction, when a meniscal allograft or synthetic substitute is used to replace the meniscus, but the biomechanical properties of the native meniscus are not reproduced entirely by the scaffolds that exist today.Conclusion: therapies that successfully repair or replace the meniscus are therefore likely to prevent or delay osteoarthritis progression.

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Long-term outcome after meniscal repair

Cited by 107 publications

References 41 publications

Meniscectomy versus meniscal repair: 10years radiological and clinical results in vertical lesions in stable knee

Meniscectomy versus meniscal repair: 10years radiological and clinical results in vertical lesions in stable knee

Dynamic Intraligamentary Stabilization (DIS) for treatment of acute anterior cruciate ligament ruptures: case series experience of the first three years

Meniscus tear surgery and meniscus replacement

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