Meta-analysis on biomechanical properties of meniscus repairs: are devices better than sutures?

Buckland, Daniel M.; Sadoghi, Patrick; Wimmer, Matthias; Vavken, Patrick; Pagenstert, Geert; Valderrábano, Víctor; Rosso, Claudio

doi:10.1007/s00167-014-2966-9

Cited by 46 publications

(35 citation statements)

References 50 publications

(50 reference statements)

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“…Where other studies showed that some meniscal repair devices have similar biomechanical properties to suture repairs. 29 Both suture repairs and devices have a place in meniscal restoration and for that reason we did not consider suture type as a contributing variable for further evaluation here.…”

Section: Discussionmentioning

confidence: 99%

Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival

et al. 2015

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Arthroscopic meniscal repair is the gold standard for longitudinal peripheral meniscal tears. The time interval between trauma and meniscal repair remains controversial. The aim of this study was to evaluate failure rates and clinical outcome of arthroscopic meniscal repair in relation to chronicity of injury. A total of 238 meniscal repairs were performed in 234 patients. Anterior cruciate ligament (ACL) was reconstructed in almost all ACL-deficient knees (130 out of 133). Time interval between injury and repair was divided into acute (< 2 weeks), subacute (> 2 to < 12 weeks), and chronic (> 12 weeks). Patients completed postal questionnaires to evaluate clinical outcome and failure rates. Study instruments included Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner scoring systems. At a median follow-up of 41 months (interquartile range [IQR], 34-53 months) 55 medial and 10 lateral meniscal repairs failed (overall failure rate, 27%). There was a significant higher failure rate for medial meniscal repair (p < 0.05) and ACL-deficient knees without ACL reconstruction. Functional outcome scores showed only significant differences on the KOOS subscale "function in daily living" (95% confidence interval, 1.05-15.27, p < 0.05). No significant difference was found for any interval between trauma and repair. The interval between trauma and arthroscopic meniscal repair has no influence on the failure rate. Differences in survival rate of meniscal repair are more dependent on location of the lesion and ACL status, rather than chronicity of injury.

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Section: Discussionmentioning

confidence: 99%

Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival

et al. 2015

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“…17,36 Additionally, medial meniscal repairs are less likely to heal than are lateral meniscal repairs. 4,7,13 Previous studies have shown failure rates of up to 40% for medial meniscal repairs. 20,29,35 …”

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confidence: 99%

Factors Affecting the Outcomes of Arthroscopically Repaired Traumatic Vertical Longitudinal Medial Meniscal Tears

Uzun

Mısır

Kızkapan

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Although numerous studies have assessed arthroscopic medial meniscal repairs, few studies have focused on factors affecting outcomes of vertical longitudinal and bucket-handle repairs.Purpose:To evaluate the factors affecting clinical outcomes of arthroscopically repaired traumatic vertical longitudinal and bucket-handle medial meniscal tears.Study Design:Case series; Level of evidence, 4.Methods:A total of 223 patients underwent arthroscopic repair for medial meniscal tears between 2007 and 2012; 140 patients had isolated tears or concurrent anterior cruciate ligament (ACL) reconstruction, and 80 patients (76 men, 4 women; mean age, 29.1 years; range, 18-49 years) had vertical longitudinal tears and were included in the study. Pre- and postoperative functional status was assessed using physical examinations with Lysholm and International Knee Documentation Committee (IKDC) scores. Barrett criteria were used for clinical assessment of meniscal healing, and magnetic resonance imaging (MRI) was used as the radiologic assessment method. The effects of tear location, length, chronicity, and type; suturing technique; concurrent ACL reconstruction; and patient age, sex, and smoking habits were also investigated.Results:The mean follow-up period was 51.2 ± 9.4 months (range, 34-85 months). The mean Lysholm and IKDC scores improved at final follow-up (both Ps <.001). According to clinical scores, Barrett criteria, and MRI, failure was noted in 12 patients (15%). There were no significant differences in age, tear length, tear type, concurrent ACL rupture, suturing technique, or location of the meniscal repair between the success and failure groups. Failure rates were higher for red-white zone tears than for red-red zone tears (10/30, 33.3% vs 2/50, 4%; P = .004). Tear chronicity significantly affected failure rates. Early repairs had higher healing rates than late repairs (100% vs 73.4%; P = .008). Failure rates were higher for smokers than for nonsmokers (9/24, 37.5% vs 3/56, 5.3%; P = .008).Conclusion:Peripheral tears and early repairs have better outcomes and patient satisfaction. Smoking adversely affects meniscal healing.

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“…The all-inside meniscal suture repair technology was first reported by Professor Craig Morgan in 1991 [26] ; however, this technology still requires an additional incision, and the operation is relatively complex. With the development of science and technology, a new generation of all-inside meniscal repair system has seen widespread use [27,28] , including the OMNISPAN™ meniscus repair system.…”

Section: Discussionmentioning

confidence: 99%

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

Shi

Fan

et al. 2019

Preprint

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Background: In consideration of meniscal repair has received increasingly more attention, but for inexperienced doctors, various technical errors may occur when meniscal suture repair is performed, particularly during all-inside meniscal suture repairing. When the errors is happened intraoperatively, how to minimize the loss under the effectiveness of treatment is a topic worth studying. Methods: From May 2014 to May 2017, 28 cases diagnosed with injures of meniscus and anterior cruciate ligaments were enrolled in the study as observation group. All cases underwent anterior cruciate ligament (ACL) reconstruction concurrently. All meniscus injuries were repaired with an allinside meniscal repair technique, and 1-3 needles of unilateral suture anchor pulling out occurred intraoperatively. The method of modified cross-suture was used to remedy the error of anchor pulling out and to eventually complete the effective repair. During postoperative follow-up, the range of motion, Lachman test and pivot shift test were confirmed by physical examination. The clinical healing of meniscus was evaluated according to the Barrett standard. Meniscus healing status was also confirmed with magnetic resonance imaging (MRI). The function of the knee joint was evaluated with the IKDC, Lysholm and Tegner scores. Results: 25 cases of observation group and 28 cases of control group received complete follow-up with an average follow-up of 18.4±5.2 months. All operations were finished by the same surgeon. Atthe follow-up one year after operation, the average knee ROM of two groups were 125.2±4.3 degrees and 124.7±3.8 degrees, the clinical healing rate of the meniscus of two groups were 92.0% (23/25) and 92.9% (26/28), the MRI healing rate of the menniscus of two groups were 72.0% (18/25) and 71.4% (20/28), the IKDC, Lysholm and Tegner scores of two groups were 90.52±2.8, 89.17±3.1, 6.81±1.7 and 91.42±1.9, 90.32±3.4, 7.02±1.4, the differences were not statistically significant (P>0.05).Conclusions: The method of modified cross-suture is effective for arthroscopic remediation for unilateral suture anchor pulling out of an all-inside meniscal repair system. BackgroundMeniscus injury is a kind of common and frequent sports injury, and its treatment should maintain the

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Meta-analysis on biomechanical properties of meniscus repairs: are devices better than sutures?

Abstract: None, meta-analysis of controlled laboratory studies.

Cited by 46 publications

References 50 publications

Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival

Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival

Factors Affecting the Outcomes of Arthroscopically Repaired Traumatic Vertical Longitudinal Medial Meniscal Tears

The modified cross-suture technique for unilateral pulled-out anchor during all-inside meniscal repair

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