Meniscus repair in the anterior cruciate deficient knee

From 1979 to 1986, isolated repair of a peripheral vascular zone meniscal tear was performed in 22 patients (23 menisci) who had ACL insufficiency. For various reasons none of these patients underwent repair or reconstruction of their ACL. The meniscus repair was done by open arthrotomy in 12 cases and by arthroscopic techniques in 11 cases. The purpose of this study was to evaluate the success rate of a meniscal repair in an anterior cruciate deficient knee. The average age of the patients at the time of surgery was 25 years and the average followup was 56 months. Six patients (26%) had mild occasional pain not requiring medication and one patient had moderate pain requiring nonnarcotic pain medication. Eight patients (26%) had occasional giving way episodes and one of them underwent ACL reconstruction 5 years later because of frequent giving way. One patient required a postoperative manipulation for inadequate range of motion, but there were no neurovascular injuries or infections. There were three patients (13%) who had failed repairs or a retear and required subsequent subtotal meniscectomies. None of the other patients had any clinical symptoms or signs of a meniscal tear. There were no significant differences between the results of open or arthroscopic repair. Even though the failure rate of meniscus repair may be greater in an unstable knee, we conclude that meniscus repair is not contraindicated in an anterior cruciate deficient knee.