title: Outcome of repaired unstable meniscal tears in children and adolescents.
abstract: BACKGROUND
  Unstable meniscal tears are rare injuries in skeletally immature patients. Loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. This study deals with the outcome of intraarticular meniscal repair and factors that affect healing. Parameters of interest were type and location of the tear and also the influence of simultaneous reconstruction of a ruptured ACL.
  
  
  METHODS
  We investigated the outcome of 25 patients (29 menisci) aged 15 (4-17) years who underwent surgery for full thickness meniscal tears, either as isolated lesions or in combination with ACL ruptures. Intraoperative documentation followed the IKDC 2000 standard. Outcome measurements were the Tegner score (pre- and postoperatively) and the Lysholm score (postoperatively) after an average follow-up period of 2.3 years, with postoperative arthroscopy and MRT in some cases.
  
  
  RESULTS
  24 of the 29 meniscal lesions healed (defined as giving an asymptomatic patient) regardless of location or type. 4 patients re-ruptured their menisci (all in the pars intermedia) at an average of 15 months after surgery following a new injury. Mean Lysholm score at follow-up was 95, the Tegner score deteriorated, mean preoperative score: 7.8 (4-10); mean postoperative score: 7.2 (4-10). Patients with simultaneous ACL reconstruction had a better outcome.
  
  
  CONCLUSIONS
  All meniscal tears in the skeletally immature patient are amenable to repair. All recurrent meniscal tears in our patients were located in the pars intermedia; the poorer blood supply in this region may give a higher risk of re-rupture. Simultaneous ACL reconstruction appears to benefit the results of meniscal repair.
authors.affiliation: Department of Pediatric Orthopaedics, Medical University of Graz, Graz, Austria. tanja.kraus@medunigraz.at
authors.forename: Tanja
authors.initials: T
authors.lastname: Kraus
authors.forename: Nima
authors.initials: N
authors.lastname: Heidari
authors.forename: Martin
authors.initials: M
authors.lastname: Švehlík
authors.forename: Frank
authors.initials: F
authors.lastname: Schneider
authors.forename: Matthias
authors.initials: M
authors.lastname: Sperl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Linhart
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods / Q000534:rehabilitation / Q000706:statistics & numerical data; D001182:Arthroscopy / Q000379:methods / Q000534:rehabilitation / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004434:Early Ambulation / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome; D016474:Weight-Bearing