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How Successful are the Results of Double-Vertical Meniscal Sutures?


Ugur Haklar, Prof., MD
TURKEY

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How Successful are the Results of Double-Vertical Meniscal Sutures?

Ugur Haklar, Prof., MD, TURKEY Ferdi Donmez, MD, TURKEY

Acibadem Kadikoy Hospital, Istanbul, TURKEY

2013 Congress   Paper Abstract   2013 Congress   rating

 

Anatomic Location

Knee

Anatomic Structure

Meniscus

Diagnosis / Condition

Tears

Sports Medicine

Sport Specific Injuries Outcome Studies

Treatment / Technique

Arthroscopy

Summary: Results of Arthroscopic Repair of Longitudinal Medial Meniscal Tears by Vertical or Double Vertical Sutures with Inside-out Technique.

Background

Although in the literature there are many articles about arthroscopic repair of meniscus tears, there are no articles about the results of double-vertical sutures.

Purpose

To present the mid-long term results of medial meniscus tears repaired with double-vertical sutures.

Study Design:
Cohort study; Level of evidence, 3.

Methods

We evaluated the results of 112 longitudinal medial meniscal tears treated with inside-out vertical or double-vertical sutures, with or without ACL reconstruction, based on clinical resolution of symptoms, assesment of Lysholm’s knee functional score with Tegner’s activity score, and re-examination by magnetic resonance imaging (MRI) after the repair. All of 112 menisci were medial. The morphology of the meniscal tears included only longitudinal tears. 45 (40%) of them were extending both superior and inferior articular surfaces, 10 (9%) were extending only superior articular surface, 36 (32%) were extending only inferior articular surface and 21 of them were displaced buckethandle tears (18%).The length of the tears was evaluated arthroscopically. 85 tears out of 112 were more than 2 cm in length, and 27 were tears of 2 cm or less. 89 of the 112 repairs (79.4%) were performed in conjunction with ACL reconstructions; the remaining 23(20.6%) repairs were performed in ACL intact knees.

Results

The cases were evaluated after a mean follow-up of duration of 49.3 months (range 12 to 88 months). According to clinical and radiologic examination, we accepted 99 (89.4%) meniscal repairs as healed. The remaining 13 cases (10.6 %) were considered as failures. The Lysholm score improved significantly from the preoperative mean value of 63.8 to a postoperative mean value of 89.5 (P<0.001). Preoperatively the mean Tegner activity score was 3.3 whereas the postoperative mean value was 6.7 (P<0.001). We found concurrent ACL reconstruction, type of the tear, length of tear, and smoking as factors that can significantly effect the meniscal healing.

Conclusion

Vertical or double vertical sutures with inside-out technique provides high rate of healing in longitudinal medial meniscal tears.

Key Terms:
Longitudinal medial meniscal tears - inside-out – double vertical suture – meniscal repair.