[Intermediate term results after arthroscopic meniscus suture].

QUESTION

Do results after arthroscopic meniscal repair justify the bigger expenditure and the longer rehabilitation opposite to the arthroscopic menisectomy?

METHOD

An arthroscopic meniscal repair in inside-out technique was carried out by the same surgeon in 35 consecutive patients with meniscal tears (tears at the meniscocapsular junction with best prognosis after repair are not subject of this study). Rehabilitation was standardized. After a mean follow-up time of 43 months, 27 (77%) of these patients, 12 without and 15 with an additional anterior cruciate ligament (ACL) reconstruction, were evaluated personally.

RESULTS

There were 4 (14.8%) reruptures (3 true reruptures, 1 "rerupture" out of the repair side) and I lesion of the N. saphenus with limited dysaesthesia. Three of the 4 reruptures occurred in patients with isolated meniscal repair, only one in patients with additional ACL-reconstruction. The functional results (Lysholm-score, knee mobility) and the subjective result were good in patients without reruptures. Postoperatively, patients were unable for work and sports for a long time, but these times being shorter for isolated meniscal repairs (5.4 and 12 weeks respectively) than for patients with an additional ACL-reconstruction (12 and 29 weeks respectively).

CONCLUSIONS

In terms of knee function and osteoarthrosis, arthroscopic meniscal repair has better results than partial meniscectomy and should be preferred, therefore, especially in young patients. A sufficient number of meniscus sutures should be performed and existing ligament instabilities should be repaired. A good rehabilitation program is essential. Efforts for a better acceptance of the method in patients and family doctors are necessary.