[Is meniscal repair an adequate procedure to prevent early osteoarthritis in athletes with chronic anterior knee instabilitity?].
We retrospectively evaluated the clinical outcome of arthroscopic assisted meniscal suture repair in athletes on different competitive sports levels with stable joint function and persisting anterior knee instability. Return to former sports levels and early osteoarthrotic changes were especially focussed. Examination included 50 athletes (32 men, 18 women) who underwent meniscal repair in inside-out technique during the period of 1989 to 1998. 23 patients had isolated full-thickness meniscal tears, 27 an associated rupture of the anterior cruciate ligament which was reconstructed in 13 cases with a patellar-tendon autograft. 3 study groups were formed referring to the athletes preoperative sports level evaluated with Tegner's score. Reexamination included Lysholm score, IKDC score and Fairbank's score. With a mean age of 32.1 years (range 13-53 years) and an average follow-up of 6.3 years 72 % of the patients (n = 36) showed a stable joint function on reexamination. With no persisting anterior knee instability 86 % of the professional athletes returned to former full sports activities on competitive levels. Non competitive athletes returned in all cases (100 %) to their former level. Fairbank's score increased by 0.1 observing minimal osteoarthitic signs. However, persisting anterior knee instability showed on reexamination poor results. Only one third of all athletes were able to return to former activity levels. Osteoarthritic changes were observed in all patients. Professional athletes had the most severe osteoarthritic changes with a significant (p = 0.03) increase of 0.8 in Fairbank's score. The results demonstrate that complete recovery on sports activities after meniscal repair is not possible without reconstruction of the anterior cruciate ligament. Isolated meniscal repair shows poor results in persisting anterior knee instability and does not prevent increasing osteoarthritic changes in athletes.
Jäger
A
A
Abt. f. Allg. Orthopädie u. Traumatologie d. Orthopädischen Universitätsklinik Frankfurt, Germany. Alwin.Jaeger@t-online.de
Braune
C
C
Welsch
F
F
Khoudeir
S
S
Rauschmann
M A
MA
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery*; 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 / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013536:Suture Techniques; D013709:Tendon Transfer; D000070600:Tibial Meniscus Injuries