Meniscal repair in the elite athlete: results of 45 repairs with a minimum 5-year follow-up.
BACKGROUND
The preservation of meniscal tissue is important to protect joint surfaces.


OBJECTIVE
We have an aggressive approach to meniscal repair, including repairing tears other than those classically suited to repair. Here we present the medium- to long-term outcome of meniscal repair (inside-out) in elite athletes.


METHODS
Case series; Level of evidence, 4.


METHODS
Forty-two elite athletes underwent 45 meniscal repairs. All repairs were performed using an arthroscopically assisted inside-out technique. Eighty-three percent of these athletes had ACL reconstruction at the same time. Patients returned a completed questionnaire (including Lysholm and International Knee Documentation Committee [IKDC] scores). Mean follow-up was 8.5 years. Failure was defined by patients developing symptoms of joint line pain and/or locking or swelling requiring repeat arthroscopy and partial meniscectomy.


RESULTS
The average Lysholm and subjective IKDC scores were 89.6 and 85.4, respectively. Eighty-one percent of patients returned to their main sport and most to a similar level at a mean time of 10.4 months after repair, reflecting the high level of ACL reconstruction in this group. We identified 11 definite failures, 10 medial and 1 lateral meniscus, that required excision; this represents a 24% failure rate. We identified 1 further patient who had possible failed repairs, giving a worst-case failure rate of 26.7% at a mean of 42 months after surgery. However, 7 of these failures were associated with a further injury. Therefore, the atraumatic failure rate was 11%. Age and size and location of the tears were not associated with a higher failure rate. Medial meniscal repairs were significantly more likely to fail than lateral meniscal repairs, with a failure rate of 36.4% and 5.6%, respectively (P < .05).


CONCLUSIONS
Meniscal repair and healing are possible, and most elite athletes can return to their preinjury level of activity.
Logan
Martin
M
Brisbane Orthopaedic and Sports Medicine Centre, Brisbane Private Hospital, 259 Wickham Terrace, Brisbane, Queensland 4000, Australia. mlogan100@hotmail.com
Watts
Mark
M
Owen
James
J
Myers
Peter
P
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000534:rehabilitation / Q000601:surgery; D054874:Athletic Performance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D011795:Surveys and Questionnaires; D000070600:Tibial Meniscus Injuries; D015599:Trauma Severity Indices; D017211:Treatment Failure; D055815:Young Adult