title: Repair integrity evaluated by second-look arthroscopy after arthroscopic meniscal repair with the FasT-Fix during anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Although several devices for meniscal repairs have become available, a successful outcome is ultimately due to a healed meniscus on the clinical findings. The authors assessed the repair integrity after meniscal repair with the FasT-Fix device using second-look arthroscopy.
  
  
  OBJECTIVE
  Meniscal repair with the FasT-Fix will lead to arthroscopically evident healing, but some menisci will show incomplete healing even in clinically successful cases and have newly formed injuries on the meniscal substance resulting from the path of the implant.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Sixty-five consecutive patients were studied, in whom 84 menisci were subjected to all-inside meniscal repair with the FasT-Fix device in conjunction with anterior cruciate ligament reconstruction. Repair was only performed on longitudinal or double longitudinal tears within the red-red or red-white zone. The repaired menisci were evaluated by second-look arthroscopy at the time of staged hardware removal after anterior cruciate ligament reconstruction.
  
  
  RESULTS
  Sixty-two meniscal tears in 46 patients were available for this study. Eight patients were found to be symptomatic and considered to be clinical failures. The clinical success rate was 83%. At second-look arthroscopy, 46 tears (74%) were healed, 9 (15%) were healed incompletely, and 7 (11%) had failed. In the failed menisci, 1 had meniscal symptoms, while the other 6 were asymptomatic. In the 9 menisci with incomplete healing, 3 were associated with nonspecific knee pain but none showed meniscal symptoms. Newly formed injuries, which occurred in an area different from the original repair site, were confirmed on the surface of 19 menisci (35%) among the healed and incompletely healed menisci. Thirty menisci (48%) displayed successful and complete healing of the original tear site without newly formed tears.
  
  
  CONCLUSIONS
  Meniscal repair with the FasT-Fix in conjunction with anterior cruciate ligament reconstruction resulted in complete healing in 74% of cases. Eighty-three percent of menisci were symptom-free regardless of meniscal integrity. Even when the menisci repaired are asymptomatic and considered to be a clinical success, however, there may be newly formed injuries.
authors.affiliation: Division of Sports Medicine, Saitama Medical University, Saitama, Japan. yomei@saitama-med.ac.jp
authors.forename: Yomei
authors.initials: Y
authors.lastname: Tachibana
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Tatsuru
authors.initials: T
authors.lastname: Goto
authors.forename: Hiromi
authors.initials: H
authors.lastname: Oda
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yamazaki
authors.forename: Soju
authors.initials: S
authors.lastname: Iida
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000209:etiology / Q000473:pathology; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D019637:Orthopedic Procedures / Q000379:methods*; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D024162:Second-Look Surgery / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult