Isolated meniscal repair in the avascular area

The authors present the results of a prospective cohort study carried out in young patients, to evaluate the outcome of meniscal repair in the avascular region of the meniscus. Forty five patients underwent either open (23 patients) or arthroscopic repair (22 patients) between 1982 and 1992. Seventeen men and eight women were included in the present study; their ages at the time of admission ranged from 16 to 27 years. They all presented with isolated longitudinal tears in the central avascular region of the meniscus. No patient with any kind of concomitant lesion was included in this series. The stitches were usually passed through the injured area and the synovium, and the knots were tightened outside the capsule. Twenty five patients of the total series, were subjected to a clinical examination in 1993, 9 to 54 months after meniscal suture. The Lysholm Knee Rating Score and the Tegner Activity Test were used. During 1999, these patients responded to a written questionnaire, based on the above mentioned rating scales. Among the 25 patients, there were 4 recurrences (16%), 2 fair results (8%) and one partial healing (4%). Eighteen (72%) patients, among which eight were treated using the arthroscopic technique, have shown favourable results, without any symptoms from the tibiofemoral joint, based on clinical examination and on the Lysholm Rating Scale and the Tegner Activity Test. When confronted with meniscal tears where there is doubt regarding the vascularity of the injured area, surgical repair in the avascular zone appears to provide a reasonable probability of healing, with good clinical outcome.