Long-term results of arthroscopic meniscal repair. An analysis of isolated tears.

From 1984 through 1986 we performed 54 arthroscopic meniscal repairs on patients with anterior cruciate ligament-stable knees. We evaluated the repair results of 52 of these patients at an average followup of 7.5 years. In 40 patients the meniscal repairs had not failed and these patients were examined clinically and radiographically; in 25 cases, magnetic resonance imaging was also performed. Significantly more failures (P < or = 0.05) occurred when the rim width of the tear was greater than 3 mm and when the tear was repaired with resorbable sutures. Conversely, the following factors were found to favorably influence meniscal healing (P > 0.05); time from injury to surgery less than 8 weeks, patient age less than 30 years, tear length less than 2.5 cm, and tear in the lateral meniscus. The overall failure rate after 7.5 years was 27% (14 of 52); 64% (9 of 14) of the failures occurred in the first 6 months after repair. The clinical and radiographic evaluation of the successfully repaired knees showed that 90% (36 of 40) had normal knee function; the remaining 10% (4 patients) had nearly normal knee function. Magnetic resonance imaging, however, showed a persisting grade 3 or 4 lesion in 96% (24 of 25) of the successfully repaired menisci and is therefore not reliable in assessing meniscal healing.