All-inside meniscal repair with bioabsorbable meniscal screws or with bioabsorbable meniscus arrows: a prospective, randomized clinical study with 2-year results.
BACKGROUND
All-inside meniscal repairs have gained popularity in the past few years. However, only a few prospective, randomized clinical studies have been done to compare different all-inside meniscal repair techniques.


OBJECTIVE
Meniscal repair with bioabsorbable meniscal screws and arrows results in similar clinical outcome on short-term follow-up.


METHODS
Randomized controlled trial; Level of evidence, 2.


METHODS
Forty-two patients were prospectively randomized to have all-inside meniscal repair either by using bioabsorbable meniscal screws or bioabsorbable meniscus arrows (21 patients, 23 meniscal repairs in each group) for the fixation. The evaluation methods were clinical examination, Lysholm score, the International Knee Documentation Committee (IKDC) knee score, and magnetic resonance arthrography (MRA) evaluation. The average follow-up time was 27 months (standard deviation, 8).


RESULTS
There were no differences between the study groups preoperatively. All 42 patients (100%) were available for the follow-up. However, during the follow-up, 11 patients had clinical failure, confirmed at second-look arthroscopy, of the repair leading to partial meniscal resection. Four failures (all on the medial meniscus) were observed with the use of meniscal screw fixation (17%), and 7 (4 on the medial meniscus, and 3 on the lateral meniscus) with the use of meniscus arrow fixation (30%) (P = .242). Six patients with meniscus arrows (29%) had chondral damage on the femoral condyles evaluated by MRA or at second-look arthroscopy, while none of the patients with the meniscal screws had the same (P = .018). However, the Lysholm and the IKDC scores were similar in both groups at follow-up.


CONCLUSIONS
All-inside meniscal repair with bioabsorbable meniscal screws and arrows resulted in similar clinical outcome, although significantly more chondral damage was observed when using bioabsorbable meniscus arrows for fixation.
Järvelä
Sally
S
Department of Orthopaedics and Traumatology, Hatanpää Hospital, PO Box 437, FIN-33101 Tampere, Finland. sally.jarvela@sci.fi
Sihvonen
Raine
R
Sirkeoja
Hannu
H
Järvelä
Timo
T
D020341:Absorbable Implants; D000328:Adult; D000704:Analysis of Variance; D001265:Athletic Injuries / Q000601:surgery*; D001863:Bone Screws; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D019637:Orthopedic Procedures / Q000295:instrumentation* / Q000379:methods; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D016896:Treatment Outcome