Arthroscopic meniscal repair results in good clinical and anatomic outcomes, according to a report in the August issue of The American Journal of Sports Medicine.
"The goal of meniscal repair is not only to obtain a stable but also a completely healed tear," Dr. Nicolas Pujol from Hopital Andre Mignot, Le Chesnay, France told Reuters Health. "Subjective outcomes are strongly correlated to the quality of healing."
Dr. Pujol and colleagues assessed outcomes and documented anatomic characteristics of arthroscopically repaired meniscus with postoperative arthrography combined with computed tomography (arthro-CT) in 53 patients between 2002 and 2004.
International Knee Documentation Committee (IKDC) scores improved significantly 12 months after meniscal repair, the authors report, and only three cases failed, requiring subsequent meniscectomy.
Among 50 cases examined by arthro-CT at 12 months, there was complete healing in 29 menisci (58 per cent), partial healing in 12 (24 per cent), and no healing in nine patients (18 per cent).
Global healing rates were significantly higher in the tears extending from the posterior to the middle segments (79.2 per cent) than in the tears confined to the posterior segment (59.8 per cent), the researchers note, but there was no difference in mean healing rate between the medial and lateral meniscus.
"By the use of posterior portals, access to the posterior tear is easier, and could improve results," Dr. Pujol commented. "A prospective comparative study about the use of posterior portals started recently in our department, with very good preliminary results."
Healing rate was not affected by type of tear, tear length, or technique used to repair the meniscal tear, the report indicates.
"In our study, the overall healing rate was correlated to the functional IKDC score," the investigators say. "This finding is reported for the first time."
"We are planning to review these patients at five and ten years, with arthro-CT scans, to state if there are some changes in the meniscal status," Dr. Pujol said. "Chondral changes will be also assessed to correlate arthritis progression with meniscal healing and meniscal narrowing."
"It is important to improve our repair technique to obtain better anatomical results and clinical results," Dr. Pujol concluded.
Am J Sports Med 2008;36:1489-1495
