Deteriorating outcomes after meniscal repair using the Meniscus Arrow in knees undergoing concurrent anterior cruciate ligament reconstruction: increased failure rate with long-term follow-up.
BACKGROUND
An increased awareness of the degenerative changes that occur in the knee after meniscectomy has led to efforts to salvage the injured meniscus. Numerous devices have been developed in an effort to provide the dual benefits of a durable meniscal repair and minimal invasiveness.


OBJECTIVE
The Meniscus Arrow is comparable to conventional inside-out suture repair in accomplishing long-term healing of meniscal tears.


METHODS
Case series; Level of evidence, 4.


METHODS
This study is an extended follow-up of an original series of 32 patients with outcomes analysis. All patients underwent meniscal repair with exclusive use of the arrow. All repairs were performed in the context of a concomitant anterior cruciate ligament reconstruction. Follow-up assessment included physical examination, arthrometry, the International Knee Documentation Committee instrument, and the Knee Disorders Subjective History visual analog scale. Intermediate follow-up at a mean of 2.3 years yielded a success rate of 90.6%. The mean follow-up in the present study has been extended to 6.6 years.


RESULTS
The extended follow-up analysis revealed a substantial attrition in the success rate of this series of patients undergoing meniscal repair with the arrow. A 90.6% success rate at a mean follow-up of 2.3 years deteriorated to 71.4% at 6.6 years.


CONCLUSIONS
This study provides the longest follow-up in the literature of any of the all-inside meniscal repair implants. The Meniscus Arrow demonstrated long-term meniscal healing rates inferior to those found in the literature for inside-out suture repair techniques.
Lee
Gregory P
GP
University of Virginia, Box 800159, Charlottesville, VA 22908, USA.
Diduch
David R
DR
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008592:Menisci, Tibial / Q000601:surgery*; D012421:Rupture; D013536:Suture Techniques; D000070600:Tibial Meniscus Injuries; D017211:Treatment Failure