ONE-YEAR FUNCTIONAL OUTCOME AFTER MENISCAL REPAIR: PROSPECTIVE ANALYSIS OF 41 MENISCI

Abstract

Purpose of the study: The aim of this prospective study was to assess functional outcome one year after meniscal repair and to correlate them with healing as assessed by arthroscan performed systematically at six months. Follow-up was 12 to 28 months.

Material and methods: Forty one meniscal repairs were included (28 medial and 13 lateral menisci). There were 33 longitudinal vertical tears, five horizontal cleavages in young athletes, one hypermobile meniscus and two complex lesions. The meniscal repair was associated with ACL reconstruction in 26 cases. In six cases, meniscal repair was an open procedure, in 34 a medial arthroscopic procedure and in one a combined arthroscopic open technique. 71% of the tears were recent, 29% were chronic. Mean length of the lesion was 21 mm. Physical examinations were performed in all patients at six weeks, and 3, 6, and 12 months. The

IKDC score was established preoperatively and at 6 and 12 months. An arthroscan was obtained at six months.

Results: There were no neurological complications related to the open approach. In three cases, the suture was loose but without subsequent intra-articular loss. There were no infections. Three patients presented recurrent meniscal tears 12 to 26 months postoperatively: secondary meniscectomy in one and a new repair in another. Therapeutic abstention was proposed for the third (a hypermobile meniscus). Mean subjective IKDC score was 67.0 points preoperatively, 73.2 at six months and 83.6 at one year. Moderate pain persisted at one year in four patients. The six-month arthroscan showed complete or incomplete (but greater than 50%) healing of the meniscal surface in 33 cases and less than 50% healing in 8. Radiologically, healing was similar for medial and lateral repairs. The joint surface was normal in all cases on the plain x-ray.

Discussion: AT 12–28 months follow-up, the rate of recurrence was low (3/41), less than in a retrospective review reported by the French Society of Arthroscopy with the same follow-up. The technique has improved.

Conclusion: The one-year functional outcome is good. Complete healing as assessed on the arthroscan does not indicate the functional outcome at this follow-up.