Arthroscopic pullout suture repair of posterior root tear of the medial meniscus: radiographic and clinical results with a 2-year follow-up.
OBJECTIVE
This study was undertaken to document the short-term clinical efficacy of arthroscopic pullout suture repair in treating posterior root tears of the medial meniscus.


METHODS
From March 2004 to August 2006, 26 patients (27 knees) with posterior root tears of the medial meniscus were treated with arthroscopic pullout suture repair surgery by the senior author. Of these, 20 consecutive patients (21 knees) with a minimum of 2 years' follow-up treated by arthroscopic pullout suture repair were analyzed. Clinical results by use of the Lysholm knee and Hospital for Special Surgery scores and radiographic grade were evaluated, both preoperatively and at final follow-up. In addition, the second-look arthroscopic findings for 10 knees were analyzed.


RESULTS
A radiographic evaluation using the criteria of Kellgren and Lawrence at final follow-up showed an increase in radiographic grade by 1 grade in only 1 knee. On the second-look arthroscopies performed in 10 knees (47.6%), all repaired menisci had healed completely without additional chondral lesions in the knee. The mean Hospital for Special Surgery scores improved from 61.1 preoperatively to 93.8 at final follow-up (P < .0001), and the mean preoperative Lysholm knee scores improved from 57.0 to 93.1 at final follow-up (P < .0001). Retear was found in 1 knee at the 6-month follow-up, and reoperation was performed with the same procedure used for the index surgery.


CONCLUSIONS
Arthroscopic pullout suture repair is an effective treatment for alleviating meniscal symptoms in patients with a symptomatic posterior root tear of the medial meniscus with degenerated articular cartilage of less than grade III. In addition, no discernable degenerative arthritic changes were found in terms of radiographic features with our limited short-term follow-up.


METHODS
Level IV, therapeutic case series.
Lee
Ju Hong
JH
Department of Orthopedic Surgery, Chonbuk National University School of Medicine, Chonbuk National University Hospital, Jeonju, South Korea.
Lim
Young Jin
YJ
Kim
Ki Bum
KB
Kim
Kyu Hyung
KH
Song
Ji Hun
JH
D000328:Adult; D001265:Athletic Injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods; D013536:Suture Techniques / Q000009:adverse effects; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult