Repair of Radial Meniscus Tears Results in Improved Patient-Reported Outcome Scores: A Systematic Review

Abstract

Purpose: To quantify healing rates and patient-reported outcome scores following repair of radial meniscus tears. Methods: PubMed, Scopus, and Embase databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria included: human subjects with meniscal tears, fulltext English language, average follow-up of at 1 year, and publication after the 2000. Exclusion criteria included technical, biomechanical, and cadaveric studies. Study quality was assessed using Coleman Methodology Scores and Methodological Index for Non-Randomized Studies (MINORS) criteria. Results: Twelve studies reported on the repair of 243 radial tears in 241 patients. The mean Modified Coleman Methodology Score was 46.8, range 26-60, with a mean level of evidence of 3.5. Arthroscopic techniques were used in all studies, with 1 study using an arthroscopic-assisted 2-tunnel transtibial pullout technique. The mean patient age was 32 years (11-71). The mean follow-up was 35 months (12 to 75.6). The average time to surgery was 10.9 months (0.5-22.4). Eight of the 12 studies reported concomitant anterior cruciate ligament (ACL) reconstruction, with 64% having concomitant ACL injury. The most common outcome measure was the Lysholm score, which improved from 47-68.9 preoperatively to 86.4-95.6 postoperatively. Tegner Activity Scale improved from 2.5-3.1 preoperatively to 4.7-6.7 postoperatively. Healing rates were reported via magnetic resonance imaging and second-look arthroscopy. Second-look arthroscopy was performed for a variety of indications, including removal of screw, washers or plates, dissatisfaction with original procedure, partial healing found on magnetic resonance imaging, or desire of the patient to know the true healing status before return to sport. Of those assessed, 62.0% had complete healing, 30.0% partial healing, and 8.0% failure to heal. Conclusions: Patient-reported outcomes of radial meniscus repair with and without ACL reconstruction are encouraging, with high patient-reported outcomes reported at final follow-up when compared with preoperative scores. Among all meniscus repairs assessed for healing, the majority demonstrated at least some healing with an overall low rate of failure. Level of Evidence: IV; systematic review of level III-IV studies.

Hybrid Repair of a Medial Meniscus Mid-Body Radial Tear

“…The authors also reported that upon second-look arthroscopy, 92% of the cases in the literature display some degree of healing, with more than 60% of cases presenting complete healing. 7 In summary, we present a hybrid technique for radial repair of the medial meniscus, employing all techniques that are found to have significant biomechanical benefit, that is backed by current biomechanical and clinical literature, reflecting the current emphasis on meniscal preservation.…”

“…3 Brazilian Society of Knee Surgery Special Issue Sociedade Brasileira de Cirurgia do Joelho Special Issue with modern developments in surgical technique has paved the way for the current emphasis on repairing even radial tears. 3,7,[9][10][11] In this video, we present a case of a medial meniscus mid-body radial tear treated with a hybrid technique of meniscal repair.…”

“…3 Improved understanding of the meniscus biological potential together with modern developments in surgical technique has paved the way for the current emphasis on repairing even radial tears. 3,7,9-11…”

“…The authors also reported that upon second-look arthroscopy, 92% of the cases in the literature display some degree of healing, with more than 60% of cases presenting complete healing. 7…”

Meniscus tears treatment: The good, the bad and the ugly-patterns classification and practical guide

“…Radial tears represent the first type of ugly lesions, because create unfavourable knee dynamic contact mechanics that are not significantly different from those resulting from meniscectomy[ 11 , 76 ] (Figure 6 and ). Such lesions seem to have a lower potential for healing than longitudinal tears[ 92 ]. Despite this, the focus on preservation of meniscal tissue has become increasingly imperative even in this context.…”