Functional outcome of arthroscopic meniscal repair in meniscal tears: a prospective study in tertiary care hospital in North India
Keywords:Meniscal repair, Sports injuries, Knee arthroscopy
Background: A Meniscal injury can result in intra articular damage and which can eventually result in osteoarthritis if not treated on time and the objective should be to save the meniscus wherever possible. This study was done to analyse the functional outcome of arthroscopic meniscal repair done in different types of Meniscal tears.
Methods: The study was conducted on a group of 28 patients with meniscal injury admitted in government medical college Jammu from November 2018 to October 2020. All the tears were located in the red-red and red-white zones. The functional outcome was assessed on the basis of Lysholm Tegner scoring. A standard rehabilitation protocol was followed post repair.
Results: Twenty-eight patients were included in the study. Male patients outnumbered the females and the incidence of injury was more on the right side. Sports injuries were the most common mode of injury, followed by road traffic accidents and falls. Bucket handle tears were most commonly seen in the group of patients. ACL injury was the major associated injury to be noted. The functional outcome between pre and post operation was statistically significant (p<0.05). In one of the patient failures was seen. Two patients were lost to follow up and were not included in the study.
Conclusions: Arthroscopic meniscal repair is a has a very good functional outcome according to our study and should be preferred over meniscectomy (subtotal or total), as meniscus being a very important shock absorber present between the knee joint can lead to delay in osteoarthritis of knee joint. Therefore, our priority should be to save the meniscus and restore the normal anatomy of the knee joint for its biomechanical stability and normal function.
Walker PS, Hajek JV. The load-bearing area in the knee joint. Biomech. 1972;5:581-9.
Voloshin AS, Wosk J. Shock absorption of meniscectomized and painful knees: a comparative in vivo study. J Biomed Eng. 1983;5:157-61.
Mac CM. The movements of bones and joints; the synovial fluid and its assistants. J Bone Joint Surg Br. 1950;32:244-52.
Zimny ML, Albright DJ, Dabezies E. Mechanoreceptors in the human medial meniscus. Acta Anat (Basel). 1988;133:35-40.
BB Seedhom, Dowson D, Wright V. Proceedings: functions of the menisci. A preliminary study. Ann Rheum Dis. 1974;33:111.
Fairbank TJ. Knee joint changes after meniscectomy. J Bone Joint Surg Am. 1948;30B:664-70.
Baratz ME, Fu FH, Mengato R. Meniscal tears: the effect of meniscectomy and of repair on intraarticular contact areas and stress in the human knee. A preliminary report. Am J Sports Med. 1986;14:270-5.
Campbell SE, Sanders TG, Morrison WB. MR imaging of meniscal cysts: incidence, location, and clinical significance. AJR Am J Roentgenol. 2001;177:409-13.
Deveci A, Cankaya D, Yilmaz S, Özdemir G, Arslantaş E, Bozkurt M. The arthroscopical and radiological corelation of lever sign test for the diagnosis of anterior cruciate ligament rupture. Springerplus. 2015;4:830.
Choi NH, Kim TH, Victoroff BN. Comparison of arthroscopic medial meniscal suture repair techniques: inside-out versus all-inside repair. Am J Sports Med. 2009;37:2144-50.
Stein T, Mehling AP, Welsch F, von Eisenhart-Rothe R, Jäger A. Long-term outcome after arthroscopic meniscal repair versus arthroscopic partial meniscectomy for traumatic meniscal tears. Am J Sports Med. 2010;38(8):1542-8.
Lutz C, Dalmay F, Ehkirch FP, Cucurulo T, Laporte C, Le Henaff G et al. French Arthroscopy Society. Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee. Orthop Traumatol Surg Res. 2015;101(8):S327-31.
Barrett GR, Treacy SH, Ruff CG. Preliminary results of the T-fix endoscopic meniscus repair technique in an anterior cruciate ligament reconstruction population. Arthroscopy. 1997;13:218-23.
Kimura M, Shirakura K, Higuchi H, Kobayashi Y, Takagishi K. Eight to 14-year follow-up of arthroscopic meniscal repair. Clin Orthop Relat Res. 2004:175-80.
Kocabey Y, Nyland J, Isbell WM, Caborn DNM. Patient outcomes following T-Fix meniscal repair and a modifiable, progressive rehabilitation program, a retrospective study. Arch Orthop Trauma Surg. 2004;124:592-6.
Austin KS, Sherman OH. Complications of arthroscopic meniscal repair. Am J Sports Med. 1990;21:864-69.
Stone RG, Frewin PR, Gonzales S. Long-term assessment of arthroscopic meniscus repair: A two- to six-year follow-up study. Arthroscopy. 1990;6:73-8.
Albertoni LJB, Schumacher FC, Ventura MHA, Da Silveira Franciozi CE, Debieux P, Kubota MS et al. Meniscal repair by all-inside technique with Fast-Fix device. Rev Bras Ortop Engl Ed. 2013;48:448-54.
Haas AL, Schepsis AA, Hornstein J, Edgar CM. Meniscal repair using the Fast-Fix all-inside meniscal repair device. Arthroscopy. 2005;21(2):167-75.
Uzun E, Misir A, Kizkapan TB, Ozcamdalli M, Akkurt S, Guney A. Evaluation of Midterm Clinical and Radiographic Outcomes of Arthroscopically Repaired Vertical Longitudinal and Bucket-Handle Lateral Meniscal Tears. Orthop J Sports Med. 2019;7:5.