Open Meniscal Repair: Clinical and Magnetic Resonance Imaging Findings After Twelve Years

Abstract

The purpose of this study was to document the longterm clinical, radiographic, and magnetic resonance imaging results after open meniscal repair. Twenty-two patients, with 23 open meniscal repairs, were evaluated after a mean follow-up of 12.9 years using patient history, physical examination, KT-1000 arthrometer testing, the "Orthopaedische Arbeitsgemeinschaft Knie" knee evaluation scheme, Tegner activity score, weightbearing radiographs, and magnetic resonance imaging. Two of the 22 patients had retears and both occurred in unstable knees. Radiographs revealed no degenerative changes in 17 of the 23 compartments. Grade III and IV signal alterations were present on magnetic resonance imaging scans in more than 50% of the repaired menisci. We concluded that the longterm survival rate of repaired menisci was 91%, and that magnetic resonance imaging is unsuitable for diagnosis of the healing process of a repaired meniscus.

Meniscal Repair Outcomes at Greater Than Five Years

“…Thirteen studies (reporting on fourteen patient cohorts) met the inclusion criteria and were the focus of the present study [10][11][12][13][14][15][16][17][18][19][20][21][22] . The studies were published between 1989 and 2011.…”

“…Four studies 11,12,14,15 utilized strict non-weight-bearing and had a pooled failure rate of 25.7% (thirty-six of 140). Seven studies 13,[16][17][18][19]21,22 (eight groups) utilized partial weight-bearing and had a pooled failure rate of 21.7% (78 of 360). A single study allowed full weight-bearing in a brace and had a failure rate of 28.6% (eight of twenty-eight) 10 .…”

“…A single study allowed full weight-bearing in a brace and had a failure rate of 28.6% (eight of twenty-eight) 10 . Six studies [11][12][13][14][15]21 utilized immobilization in a cast or splint postoperatively for at least four weeks and had a pooled failure rate of 23.7% (forty-seven of 198). Six studies 10,[16][17][18][19]22 (seven groups) allowed some degree of gentle early range of motion and had a pooled failure rate of 22.7% (seventy-five of 330).…”

“…19,2012 of acute and chronic tears provided in the individual studies, the pooled failure rates were 16.3% (eight of forty-nine) for acute tears and 15.5% (nine of fifty-eight) for chronic tears. Seven groups in six studies 13,15,[19][20][21][22] included detailed information on the vascular zone of the meniscal tears. Red-red meniscal zone repair had a pooled failure rate of 20.9% (twenty-nine of 139).…”

“…The repair technique was open in five cohorts [11][12][13]15,21 , inside-out in five 14,[18][19][20]22 , outside-in in one 16 , and all-inside (with use of meniscal arrows) in three 10,17,22 . The Appendix summarizes the patient populations and follow-up durations of the included studies.…”