Second-look arthroscopic evaluation of bucket-handle meniscus tear repairs with anterior cruciate ligament reconstruction: 67 consecutive cases.
OBJECTIVE
To evaluate arthroscopic second-look bucket-handle meniscus tear (BHMT) repairs using different suturing techniques.


METHODS
Between May 2002 and September 2006, 122 consecutive cases underwent arthroscopic repair surgery, including 40 males and 24 females (63 with concurrent anterior cruciate ligament [ACL] injury and 1 isolated BHMT) having 67 (60 medial and 7 lateral) repairs available for second-look arthroscopy evaluation. Inclusion criteria for reparability included reducible tears involving red-red and red-white zone without obvious additional complex tears and tissue degeneration, and concurrent ACL injury and/or isolated BHMT. Patients were excluded if they had combined ligaments injuries other than ACL. The arthroscopic suturing techniques, classified according to different involvement of meniscus zones, consisted of typical inside-out and all-inside suture repair with suture hook.


RESULTS
In a series of 64 second-look cases with 67 repairs, which showed healing after an average of 26 months (range, 14 to 66 mos), 55 repairs (82.1%) were completely healed (and clinically asymptomatic) in 53 cases; 5 cases (5 repairs; 7.5%) had joint line tenderness (incompletely healed and clinically asymptomatic); and 7 repairs (6 medial, and 1 lateral; 10.4%) failed, with recurrent locking or catching in 4 cases (and clinically asymptomatic in 2 cases). The overall success rate, including completely healed and incompletely healed cases, was 89.6%. Four failures occurred in failed ACL-reconstructed knees.


CONCLUSIONS
For large bucket-handle meniscus tears involving red-red and red-white zones, an arthroscopic hybrid suture technique with ACL reconstruction achieves high anatomic healing results, with an overall meniscal healing rate of 89.6%, including 82.1% completely healed and 7.5% incompletely healed. The failure rate was 10.4% in the average 26-month follow-up period.


METHODS
Level IV, therapeutic case series.
Feng
Hua
H
Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China. yzyfh@public3.bta.net.cn
Hong
Lei
L
Geng
Xiang-su
XS
Zhang
Hui
H
Wang
Xue-song
XS
Jiang
Xie-yuan
XY
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D018579:Patient Selection; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods* / Q000534:rehabilitation; D000070600:Tibial Meniscus Injuries; D017211:Treatment Failure; D016896:Treatment Outcome; D014945:Wound Healing