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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Etiology of Posterior Meniscus Root Tears: Medial vs. Lateral ePoster Presentation Katrin Karpinski, MD, GERMANY Philipp Forkel, MD, GERMANY Martin Häner, MD, GERMANY Wolf Petersen, MD, Prof, GERMANY
Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres ePoster Presentation Rainer Siebold, Prof. Dr. med., GERMANY Johannes Pawelczyk, cand. med., GERMANY
Arthroscopic Treatment of Meniscal Cysts and Clinical Follow Up ePoster Presentation Sang Hak Lee, MD, PhD, KOREA, REPUBLIC OF Tae Wook Kim, MD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF Jun Bum Park, MD, KOREA, REPUBLIC OF Min-Gyu Kim, MD, KOREA, REPUBLIC OF
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Clinical Outcomes with Meniscal Repair, Between 2019-2020, Viña del Mar, Chile (Preliminary Study) ePoster Presentation Sergio Patricio González Rouse, MD, MSc, MBA, CHILE Raul Roz, MD, CHILE Horacio Alejandro Carvajal Araya, MD, CHILE
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Can Local Anesthesia be Considered as Gold Standard in Knee Arthroscopy? ePoster Presentation Tilemachos Papageorgiou, MD, GREECE Stefanos Christos Papageorgiou, MD, GREECE ILIAS SOTIRIADIS, MD, GREECE Tsoumanis Dimitrios, MD, GREECE Christos D. Papageorgiou, MD, PhD, GREECE
Predictors of The Ten-Year Patient-Reported Outcome Measures After Collagen Meniscus Implant (CMI) For Partial Meniscus Deficiency ePoster Presentation Alberto Grassi, PhD, ITALY Gian Andrea Lucidi, MD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Giacomo Dal Fabbro, ITALY Nicola Pizza, MD, ITALY Marianna Viotto, ITALY Luca Ambrosini, MD, ITALY Stefano Zaffagnini, MD, Prof., ITALY
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Less Than 10% Failure Rate in Patients with Bucket-Handle Meniscal Tear Repair After 4 Years Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Ignacio Astore, MD, ARGENTINA Carlos H. Yacuzzi, MD, ARGENTINA Matias Costa-Paz, MD, PhD, ARGENTINA Juan Pablo Zicaro, MD, ARGENTINA
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Bidirectional Evaluation for the Lateral Meniscal Extrusion After Repairing Isolated Longitudinal Tear ePoster Presentation Akira Tsujii, MD, PhD, JAPAN Seira Sato, MD, PhD, JAPAN Tomoki Ohori, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yasukazu Yonetani, MD, PhD, JAPAN Masayuki Hamada, MD, JAPAN Ken Nakata, MD, PhD, JAPAN
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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
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Posterior Cruciate Buckling Angle Variations are Associated With Different Patterns of Medial Meniscus Tears in Anterior Cruciate Deficient Knees: Results of a Prospective Comparative Magnetic Imaging Resonance Study ePoster Presentation Simone Cerciello , DR, ITALY Gianluca Ciolli, MD, ITALY Dario Candura, ITALY Michele Mercurio, Prof., MD, ITALY Fabrizio Mocini, MD, ITALY Lorenzo Proietti, MD, ITALY
A New Arthroscopic Pull-In All-Suture Anchor Meniscus Root Tear Repair Shows Comparable Biomechanical Properties as Conventional Trans-Osseous Pull-Out and Anchor Repair ePoster Presentation Thorben Briese, MD, GERMANY Amaris Kieninger, MD, GERMANY Elmar Herbst, MD, PhD, GERMANY Johannes Glasbrenner, MD, GERMANY Christian Peez, MD, GERMANY Adrian Deichsel, MD, GERMANY Maurice Balke, MD, GERMANY Jens Wermers, MD, GERMANY Matthias Klimek, M. Sc., GERMANY Michael J. Raschke, MD, Prof., GERMANY Christoph Kittl, MD, MD(res), GERMANY
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Lateral Meniscal Posterior Root Repair with Concurrent ACL Reconstruction: Patient-Report Outcomes and Risk Factors for Failure ePoster Presentation Evan W. James, MD, UNITED STATES Per-Henrik Randsborg, MD, PhD, NORWAY Joseph T. Nguyen, MPH, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Answorth A. Allen, MD, UNITED STATES Scott A. Rodeo, MD, UNITED STATES Robert G. Marx, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
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Good Clinical Results And Patient Satisfaction After Arthroscopic Repair of Large Meniscus Bucket Handle Tears of the Knee ePoster Presentation Johannes Pawelczyk, cand. med., GERMANY Rainer Siebold, Prof. Dr. med., GERMANY
Mid-Term Clinical And Radiological Outcomes of Lateral Meniscal Allograft Transplantation With Suture-Only Fixation Plus Capsulodesis ePoster Presentation Àngel Masferrer-Pino, MD PhD, SPAIN Rodolfo Morales-Avalos, MD, PhD., MEXICO Maximiliano Ibañez, MD, SPAIN Simone Perelli, MD,PhD, SPAIN Pablo E. Gelber, MD, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Meniscal And Cartilage Changes On MRI 5-9 Years After Medial Opening-Wedge High Tibial Osteotomy ePoster Presentation Satomi Abe, MD, PhD, JAPAN Keisuke Matsukura, UNITED STATES
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
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
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Delaying ACL Reconstruction Increases the Risk of Medial Meniscal Tear ePoster Presentation Julien Erard, MD, FRANCE Nicolas Cance, MD, FRANCE Jobe Shatrov, MD, AUSTRALIA Gaspard Fournier, MD, FRANCE Stanislas Gunst, MD, FRANCE Gianluca Ciolli, MD, ITALY Pasquale Porcelli, MD, ITALY Sebastien Lustig, MD, PhD, Prof., FRANCE Elvire Servien, MD, PhD, Prof., FRANCE
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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
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
Determinants of Radiologic and Functional Outcomes after Meniscal Repair of Longitudinal Vertical Tears. A Prospective Cohort Study of 78 patients. ePoster Presentation Benjamin Tschopp, MD, SWITZERLAND Robin Martin, MD, SWITZERLAND
Large Posterolateral Cartilage Slope Is a Risk Factor for Noncontact ACL Injury ePoster Presentation Kensuke Hotta, MD, JAPAN Mitsuru Hanada, MD, PhD, JAPAN Kazuki Nomoto, MD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Predictors of Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction With Concurrent Treatment of Bucket-Handle Meniscus Tears ePoster Presentation Gregory Perraut, MD, UNITED STATES Rachel E Cherelstein, BS, UNITED STATES Alexandra Galel, MD, UNITED STATES Laura Keeling, MD, UNITED STATES Christopher M Kuenze, PhD, UNITED STATES Andrew Curley, MD, UNITED STATES David X. Wang, MD, UNITED STATES Kaitlin A Malekzadeh, , UNITED STATES Edward S. Chang, MD, UNITED STATES
Accuracy of Magnetic Resonance Imaging for Detecting Meniscal Tears in Anterior Cruciate Ligament injuries. ePoster Presentation Artit Boonrod, MD, THAILAND Watcharapong Wongsawiang , MD, THAILAND Punthip Thammaroj , MD, THAILAND Sermsak Sumanont, THAILAND Punyawat Apiwatanakul, MD, THAILAND Arunnit Boonrod, MD, THAILAND
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
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
The Hidden Lesion of the Knee: Risk Factors Study ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Anis Tebourbi, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Rami Triki, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
Medial Meniscus Repair only Partially Restores In-Vivo Knee Kinematics after ACL Reconstruction ePoster Presentation Alberto Grassi, PhD, ITALY Piero Agostinone, MD, ITALY Stefano Di Paolo, Eng, ITALY Gian Andrea Lucidi, MD, ITALY Erika Pinelli, MsC, ITALY Gregorio Marchiori, MD, ITALY Marco Bontempi, PhD, ITALY Laura Bragonzoni, Prof., ITALY Stefano Zaffagnini, MD, Prof., ITALY
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
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
Clinical Outcomes Of Lateral Meniscus Posterior Root Repair In The Acl-Reconstructed Knees ePoster Presentation Lika Dzidzishvili, MD, PhD, SPAIN Irene Isabel López-Torres, MD, PhD, SPAIN David Sáez, MD, SPAIN Antonio Hernández Diez, MD, SPAIN Emilio Calvo, MD, PhD, MBA, 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
Concomitant Medial Meniscal Ramp Lesions and Lateral Meniscal Tears with Anterior Cruciate Ligament Injuries are Associated with Anterior Tibial Subluxation in Knee Extension ePoster Presentation Hibiki Kakiage, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Satoshi Nonaka, MD, JAPAN Masanori Terauchi, MD, JAPAN Atsufumi Oshima, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
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
Comparing the Risk of Iatrogenic Peroneal Nerve Injury in All-inside Lateral Meniscus Repair between Preoperative and Real Arthroscopic Position MRIs ePoster Presentation Chaiwat Chuaychoosakoon, MD, THAILAND Wachiraphan Parinyakhup, MD, THAILAND Tanarat Boonriong, Principal, THAILAND
A Comparison of Clinical Outcomes Of Discoid Versus Standard Meniscus Tear Procedures: A Systematic Review ePoster Presentation Yi (David) Diao, BMSc, CANADA Prushoth Vivekanantha, MD, CANADA Dan Cohen, MD, CANADA Yuichi Hoshino, MD, PhD, JAPAN Kanto Nagai, MD, PhD, JAPAN Darren L. de SA, MD MBA FRCSC, CANADA
Biomechanical Comparison Of Novel Meniscus Cap Repair Technique With Simple Meniscus Suture And Collagen Matrix Meniscus Suture Techniques For Complex Tears Of The Medial Meniscus ePoster Presentation Kinga Ciemniewska-Gorzela, PhD, POLAND
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 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

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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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