2023 ISAKOS Biennial Congress ePoster
Clinical Outcomes After the Repair of Isolated Full Radial Tear at Midbody of Lateral Meniscus - All-Inside Suture Repair vs Trans-Capsular Suture Repair -
Ryohei Uchida, MD, PhD, Amagasaki, Hyogo JAPAN
Shuji Horibe, MD, PhD, Habikino, Osaka JAPAN
Yoshinari Tanaka, MD, PhD, Ibaraki, Osaka JAPAN
Kazutaka Kinugasa, MD, PhD, Sakai, Osaka JAPAN
Yuta Tachibana, M.D., Ph.D., Sakai, Osaka JAPAN
Akira Tsujii, MD, PhD, Suita, Osaka JAPAN
Konsei Shino, MD, PhD, Osaka, Osaka JAPAN
Kansai Rosai Hospital, Amagasaki, Hyogo, JAPAN
FDA Status Not Applicable
Summary
We compared 6-month postoperative healing on arthroscopy and meniscal extrusion as well as 2-year postoperative clinical score between all-inside suture repair (AIS) and inside-out repair (IO) for isolated radial tears at midbody of the lateral meniscus. Two repair techniques were comparable satisfactory clinical results with low rates in complete healing. However, AIS could minimize postoperativ
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Abstract
Introduction
In young athletes, the radial tear of the midbody is most common on semilunar lateral meniscus in stable knees [Terzidis IP et al. AJSM 2006]. Conventionally, for this type of tear, meniscectomy has been considered as a first-line treatment. However, meniscectomy does not prevent degenerative change. Therefore, the repair would be another treatment option for the full radial tear. But this type of tear can be difficult to repair due to lack of the vascular supply. There has been reported rarely on the repair for the isolated radial tear at midbody of lateral meniscus (RMLM) with sufficient short-term clinical outcomes and low rate of arthroscopic complete healing [van Trommel MF et al. Arthroscopy 1998, Ra HJ et al. KSSTA 2013, Tsujii A et al. JOS 2017].
Recently, new devices for all-inside suture (AIS) repair that require no trans-capsular suture (TCS) have been developed. AIS repair is considered more suitable for restoration of meniscal morphology and movement compared to conventional TCS repair, including inside-out repair. Actually, biomechanical study showed higher failure load and stiffness after AIS repair for radial tear of porcine meniscus compared with inside-out repair [Beamer BS et al. Arthroscopy 2015]. Another report described that tibiofemoral contact pressure after AIS repair for radial tear of cadaveric meniscus tended to be lower than that after inside-out repair without significant difference [Zhang AL et al. Knee 2015]. These features of AIS could be advantageous for meniscal healing. However, there have been no comparative studies between AIS repairs and TCS repairs for RMLM.
Objectives: To evaluate the clinical outcomes of AIS and TCS repair for isolated RMLM.
Methods
Thirteen athletes (average age of 18.5 years) underwent AIS repairs with double horizontal suture technique, using SutureLasso™ (Arthrex, Naples, FL) for RMLM (Group A), and 20 patients (average age of 19.8 years) underwent inside-out repairs with tie-grip suture technique (Group I). All patients were evaluated for a two-year postoperative KOOS, preoperative and six-month postoperative MRI, and six-month postoperative second-look arthroscopy.
Results
All subscores of KOOS were improved to good or excellent in most patients postoperatively. On second-look arthroscopic evaluations, complete healing was found in only 15 to 20% of patients. There were no differences between two groups in KOOS and arthroscopic healing. However, the change from preoperative to postoperative meniscal body extrusion in group A was significantly less than that in group I (P=0.03).
Conclusion
AIS and TCS repair for RMLM were comparable in providing satisfactory clinical results with low rate of arthroscopic complete healing. However, AIS repair could minimize postoperative meniscal body extrusion compared with TCS repair, which would be better for healing.