Arthroscopic meniscal repair with two‐year follow‐up: A clinical review

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Abstract
Summary: The potential for healing of meniscal tissue has been historically underappreciated, but is currently more widely acknowledged. We have reviewed our experience with arthroscopic meniscal repair in 29 patients who had had a minimum of 2 years' follow‐up. Between September 1983 and November 1986, 31 patients who had undergone arthroscopic meniscal repair with a minimum of 2‐years' follow‐up were identified. Of the 31 patients, 29 were available for additional follow‐up. The patient population averaged 31 years of age, with 15 men and 14 women. Utilizing a closed arthroscopic cannulated technique, 16 lateral and 15 medial menisci were repaired. The majority of lesions were vertical bucket‐handle tears involving the posterior horn and averaged 2.5 cm in length. Of the 31 tears, 29 were in the red‐red or red‐white zones. Clinical healing was present in 27 (87%) of the 31 repaired menisci. Nine patients underwent relook arthroscopy at which time healing was confirmed in eight, and a retear noted in one. Four reruptures occurred and the menisci required removal. Of the 29 patients, 16 had concomitant anterior cruciate ligament injuries ranging from partial tears to complete disruptions. Seven patients underwent immediate or delayed anterior cruciate ligament stabilization. Healing occurred in six of the seven patients whose anterior cruciate ligaments had been reconstructed. Among those patients with reruptures, chronic anterolateral rotatory instability was identified as a significant risk factor for rerupture. A complication rate of 13% was noted. Three patients underwent manipulation under anesthesia for postoperative ankylosis and one patient experienced a transient saphenous nerve neuropraxia. Arthroscopic anterior cruciate ligaments repair remains a desirable alternative to meniscal excision and has excellent results when proper selection and technique are implemented.

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