Summary: Due to older age often being considered a criterion to not perform meniscal, a meta-analysis was performed to establish outcomes of meniscal repair in older patients: a low failure rate and good patient-reported outcomes in older patients receiving meniscal repair was observed and these outcomes were not lower than following meniscal repair in younger patients.

Background

Meniscectomy has been demonstrated to lead to long-term deterioration in function and a high risk of osteoarthritis and total knee arthroplasty. These negative effects can be reduced through meniscal preservation. However, despite the long-term benefits of meniscal repair, it appears to be less commonly adopted in “older” populations due to a concern that they are less likely to be successful.

Purpose

To establish the success rates and patient outcomes of meniscal repair in “older” patients (=40 years) and how this compares to “younger” patients (<40 years).

Methods

A systematic literature review was performed to identify published English-language studies that reported on meniscal repair in =5 patients aged =40 years. Outcomes of interest were success/failure (as defined by the study), revision meniscus procedures and patient-reported outcomes. Meta-analyses were used to synthesize outcomes across all studies in older patients. Meta-analyses were also used to provide a comparison in outcomes between older and younger patients across studies providing data on both age groups.

Results

Sixteen articles (15 studies) were identified. Meniscal repair in older patients was identified to have a success rate of 87.5% (95% confidence interval (CI): 80.9 – 92.0; 14 studies) and a revision meniscus procedure rate of 10.0% (95% CI: 7.4 – 13.4; 9 studies). Post-operative International Knee Documentation Committee scores were 76.9 (95% CI: 69.2 – 84.5; 4 studies) and Lysholm scores were 86.7 (95% CI: 81.7 -91.7; 4 studies). Older patients were less likely to experience a failure (relative risk [RR], 0.60; 95% CI: 0.44 – 0.83; p = 0.002; 10 studies) or revision meniscus procedure (RR, 0.60; 95% CI: 0.43 – 0.84; p = 0.003; 7 studies) and had similar Lysholm scores (?2.3; 95% CI: -4.7 – 9.2; p = 0.5278, 3 studies) compared with younger patients.

Discussion

Meniscal repair in older patients can be performed successfully with a low failure rate and good patient-reported outcomes. Included studies may have inherent selection bias with selected older patients having tears that may be most amenable to repair. However, this study does demonstrate that repair can be performed in at least a portion of older patients and that age per se should not be a sole determining factor in the selection to perform a meniscal repair or not.

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"Repair Or Resect? That Is The Question!" Inside-Out Repair Of Long Meniscus Tears Is Used to Identify Prognostic Factors and Improve Decision-Making ePoster Presentation Iftach Hetsroni, MD, Associate Prof., ISRAEL Yakir Carmeli, B.Ed., ISRAEL Shiri Bretter, M.ed, ISRAEL Gabriel Marino, MD, ISRAEL Ayelet Gonen-Vonkler, BA, ISRAEL Altaieb Agbaria, MD, ISRAEL Gideon Mann, MD, Prof., ISRAEL Nissim Ohana, MD, ISRAEL Moshe Ayalon, PhD, ISRAEL
Comparison Of Resultant Force Through The Repaired Lateral Meniscus With Between Inside-Out And All-Inside-Suture Techniques ePoster Presentation Takehito Hirose, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Satoshi Yamakawa, PhD, JAPAN Issei Ogasawara, PhD, JAPAN Shoji Konda, PhD, JAPAN Yasuhiro Take, MD, PhD, JAPAN Ken Nakata, MD, PhD, JAPAN
Biomechanical Effect of Unstable Meniscal Injury on Gait in ACL-Deficient and -Reconstructed Knees ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Yasuo Niki, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
Virtual Reality Simulation is Valuable for Arthroscopic Diagnosis and Meniscectomy: A Transfer Validity Study of 36 Residents ePoster Presentation Alexandre Tronchot, MD PhD, FRANCE Tiphaine Casy, PhD, FRANCE Nicolas Vallee, MD, FRANCE Harold Common, MD, FRANCE Hervé Thomazeau, PR, FRANCE Pierre Jannin, PhD, FRANCE Arnaud Huaulme, PhD, FRANCE
Risk Factors Affecting the Survival Rate of Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency. An Analysis Of 156 Consecutive Cases at A Mean 10 Years of Follow-Up ePoster Presentation Gian Andrea Lucidi, MD, ITALY Alberto Grassi, PhD, ITALY Piero Agostinone, MD, QATAR Stefano Di Paolo, Eng, PhD, ITALY Giacomo Dal Fabbro, MD, AUSTRALIA Nicola Pizza, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
Meniscus Repair Augmentation Using Blood Clot ePoster Presentation Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA John Dabis, MBBS, MSc SEM, MRCS, FRCS(Tr&Orth), UNITED KINGDOM Michael Goldberg, MBBS, FRACS, AUSTRALIA Andrew Stillwell, MBBS(Hons), FRACS, FA(ortho)A, AUSTRALIA
Strength-Based Rehabilitation On Clinical Outcomes In Patients Post-Meniscectomy: A Systematic Review and Meta-Analysis ePoster Presentation Prushoth Vivekanantha, MD, CANADA Yi (David) Diao, BMSc, CANADA Dan Cohen, MD, CANADA Ben Murphy, DPT, CANADA Darren L. de SA, MD MBA FRCSC, CANADA
Clinical Characteristics Of Isolated Meniscal Tears During Sports Activities Among Young Athletes ePoster Presentation Yuta Tachibana, M.D., Ph.D., JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Hiroshi Amano, MD, PhD, JAPAN Keisuke Kita, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN
Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images ePoster Presentation Shunya Tsuji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Naofumi Hashiguchi, MD,MPH, JAPAN Goki Kamei, MD, PhD, JAPAN Atsuo Nakamae, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN
Evolution in the Indication of Surgical Treatment on Degenerative Meniscal Tears In the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age ePoster Presentation Kevin R. Stone, MD, UNITED STATES Ann W. Walgenbach, RN, NP, MSN, UNITED STATES Shadera Slatter, MS, UNITED STATES Thomas J. Turek, PhD, UNITED STATES Caroline Ferguson-Dryden, BA, UNITED STATES Marie Dicker, BASc, UNITED STATES Emma Miltenberger, BS, UNITED STATES Riley Horn, BS, UNITED STATES Haley Cowles, BA, UNITED STATES Vivian Liu, BA, UNITED STATES Stephanie Wu, BS, UNITED STATES Mani Vessal, MA, PhD, UNITED STATES
Evolution in the Indication of Surgical Treatment on Repairable Meniscal Tears and Their Treatment in the Last 20 Years ePoster Presentation Alejandro Espejo-Reina, MD, MSc, SPAIN Enrique Sevillano-Perez, MD, SPAIN María Josea Espejo-Reina, MD, SPAIN Maximiano Lombardo-Torre, SPAIN Miguel Verdejo-Parrilla, MD, MSc, SPAIN Alejandro Espejo-Baena, MD, SPAIN
Lateral Meniscus Root Tear in ACL-Injured Patients Results In High-Grade Rotatory Knee Laxity: A Quantitative Pivot Shift Analysis ePoster Presentation Bálint Zsidai, MD, SWEDEN Gian Andrea Lucidi, MD, ITALY Ryosuke Kuroda, MD, PhD, JAPAN James J. Irrgang, PT, PhD, FAPTA, UNITED STATES Kristian Samuelsson, Prof, MD, PhD, MSc, SWEDEN Stefano Zaffagnini, MD, Prof., ITALY Volker Musahl, MD, Prof., UNITED STATES
Clinical Outcomes After the Repair of Isolated Full Radial Tear at Midbody of Lateral Meniscus - All-Inside Suture Repair vs Trans-Capsular Suture Repair - ePoster Presentation Ryohei Uchida, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yuta Tachibana, M.D., Ph.D., JAPAN Akira Tsujii, MD, PhD, JAPAN Konsei Shino, MD, PhD, JAPAN
Associated Fracture of Spinal Tuberosity with Anterior Root Injury of Lateral Meniscus ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Rami Triki, TUNISIA Mohamed Hedi Ezzine, MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Postoperative Subjective Evaluation after Meniscectomy in Patients Older than 70 Years: A Local Retrospective Study ePoster Presentation Ignacio Fernández, Md, CHILE Francesca Castelletto, MD, CHILE Enrique Sebastián Rubio, Md, CHILE Rodrigo Humberto Garcia, MD, CHILE Roberto Cisternas, md, CHILE Ignacio Lopez, CHILE
Outcomes of Arthroscopic All-Inside Repair are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears ePoster Presentation Kyoung Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF

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Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis

Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis

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Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis

Meniscal Repair Is A Solution In “Older” Patients: A Systematic Literature Review with Meta-Analysis

Background

Purpose

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Discussion

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