Summary

This technique provides cost effective robust repair of meniscal repair in foot ballers and allow accelerated rehab and faster return to play

Abstract

Aim

To asses the functional outcome of novel cost effective technique of meniscal repair in footballers

Background

Eventhough meniscal repair is the ideal treatment for most of the meniscal tears, especially in young footballers, due to cost constraints and prolonged rehab partial or subtotal meniscectomy was commonly performed.
We developed a cost effective and robust technique of meniscal repair using minimum armamentarium and less technical expertise by which almost all patterns of meniscal tears in vascularised zones can be repaired perfectly Patient can undergo accelerated rehab and early return to play

Method

Prospective longitudinal study was conducted on a group of 114 footballers who underwent meniscal repair using this technique in orthopaedic department Ems memorial cooperative Hospital Perinthalmanna from September 2022 to January 2024.

Inclusion criteria
All meniscal repairs done in footballers using the above technique in isolation

Exclusion criteria
All meniscal repairs done using a combination of technique and non footballers

Technique
Under Spinal anesthesia and Tourniquet control after surface marking through std Anterolateral and Anteromedial portals diagnostic scopy was done. Meniscal tear location, pattern identified classified repairability checked. Meniscal rasping and preparation done.Using 18 gauge 1.5 inch hollow disposable needles loaded with nitinol wire loop penetrated percutaneously from outside in through desired points on either sides of meniscus tear and nitinol wire loop pushed in to joint retrieved through the working portal and exchanged with one zero or two zero fibre wires.
Same procedures repeated in every 3 to 4 mm length of meniscal tears in vertical mattress pattern W configuration in both horizontal and vertical planes to achieve a robust repair.
Associated injuries were addressed along with the repair. Sliding Knots are tied outside the capsule through separate skin incision either medial or lateral.
Post op immediate tolerable weight bearing started and patient was put on Accelrated rehab protocols, sports specific exercises, Neuromuscular coordination training, agility ,plyometrics and early return to play by maximum of 6 months post op once he cleared fitness and trials.The functional outcome was assessed on the basis of Tegner Lysholm score.

Results

6 months post surgery the average Tegner Lysholm score was 92/100.9 patients had minor complication. one patient had retear after a reinjury.Most of them returned to sports by 6 months after accelerated rehab

Discussion

This cost effective technique provides robust repair in all pattern of meniscal tears both medial and lateral except root tears and displaced radial tears. Accelerated rehab protocols can be initiated and early return to play is assured following this technique.