Outcomes of meniscal preservation using all-inside meniscus repair devices

The thrust of meniscal surgery has now moved toward meniscal preservation. Repair is particularly indicated on the lateral side where the sequelae of resection are severe even in an older patient population.

The aim of this study was to analyze the success of all-inside meniscus repairs in a carefully selected patient population.

Three hundred twelve repairs were performed in 288 patients with a mean age of 32 years (range, 17-46 years). One hundred seventy-one lateral menisci and 141 medial menisci were repaired. The minimum followup was 12 months (mean, 18 months; range, 12-55 months). Medicolegal cases, major trauma, and knee dislocations were excluded. Failure was defined as persistent meniscal symptoms beyond 16 weeks, an MRI diagnosis of a nonhealed meniscal tear beyond 52 weeks, reoperation for the meniscal tear, and failure to return to the patient's previous functional level.

There were three painful capsular sutures that required removal, two cases of complex regional pain syndrome, and two deep venous thromboses. The repair failed in 6% of cases with associated ACL reconstruction and 14.1% of cases without ACL reconstruction. Repeat surgery was typically performed at a mean of 16 months (range, 1-44 months).

At short-term followup, all-inside meniscus repairs have good outcomes in the majority of highly selected cases, although this was a very selected cohort with a large number of associated ACL reconstructions.

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.