[Can meniscus refixation prevent early development of arthrosis in the knee joint? Long-term results].
This retrospective study presents the long-term results after meniscal repair with emphasis on early-development of osteoarthritis in the knee. From 1984 to 1996 meniscal repair using the inside-out technique was performed on 54 patients. 25 patients had an isolated tear of the meniscus and 29 additionally a tear of the anterior cruciate ligament (ACL, combined injury). 18 patients of those with a combined injury showed a stable knee during clinical follow-up. A separate evaluation of this group was carried out. The mean follow-up was 6.4 years. 22 patients were examined over a period of 2-5 years (mean 3.5) after surgery, 32 patients after 5 years (mean 8.9). The clinical evaluation was carried out using IKDC, Tegner activity scale, Lysholm, and Tapper and Hoover-Score as well as the Fairbank radiographic evaluation. According to the Fairbank's evaluation the results show that up to 5 years after meniscal repair only minimal radiographic changes were detectable. In only 21% of patients with an isolated meniscal lesion and in 13% of those with a stable knee after a combined injury beginning of osteorathritic changes were noted more than 5 years postoperatively. Early osteoarthritic changes were present within 5 years after surgery in non-stable knees (untreated rupture, suturing). Patients with meniscal repair mostly regain their original Tegner activity level and good to very good results in the clinical scores. However, the results clearly indicate that the success of meniscal repair depends on the stability of the knee. Thus, meniscal repair in stable knees is recommended to prevent early development of osteoarthritis.
Orthopädische Universitätsklinik, Friedrichsheim, Frankfurt/M.
A
A
Jäger
M
M
Starker
J
J
Herresthal
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome