O'Shea John J, Shelbourne K Donald
Methodist Sports Medicine Center, Indianapolis, Indiana, USA.
Am J Sports Med. 2003 Mar-Apr;31(2):216-20. doi: 10.1177/03635465030310021001.
Large bucket-handle meniscal tears in knees with chronic anterior cruciate ligament deficiency have been considered avascular and, thus, irreparable.
The rate of meniscal healing is higher than previously reported.
Prospective cohort study.
Fifty-nine patients underwent staged surgical procedures of meniscal repair followed at an average of 77 +/- 58 days by ligament reconstruction once full range of motion was obtained.
Fifty-two patients with 55 meniscal repairs were available for follow-up. At reconstruction, 30 menisci (55%) appeared healed; 19 (34%), partially healed; and 6 (11%) showed no healing (only 4 were removed). Of 43 tears in the white-on-white zone, 21 appeared healed; 17, partially healed; and 5 showed no healing. Of 11 in the red-on-white zone, 8 appeared healed; 2, partially healed; and 1 showed no healing. One meniscal tear in the red-on-red zone appeared healed. At an average follow-up of 4.3 +/- 3.1 years, 36 of the 43 (83.7%) white-on-white meniscal repairs remained asymptomatic; all repairs in the other zones remained asymptomatic.
Locked bucket-handle meniscal tears heal at a high rate when repaired as an isolated procedure, even when full weightbearing and activity before reconstruction is allowed and when the tear is in the white-on-white zone.
