Clinical outcomes of open meniscal repair of horizontal meniscal tears in young patients.
OBJECTIVE
Symptomatic horizontal meniscal tears in young patients are a singular entity. The extent of the lesion is often large, without any injury to the knee. The meniscal tissue might be degenerative. However, a complete resection of the lesion would result in a subtotal meniscectomy. The purpose of this study was to consider the use of a meniscal repair in such patients in order to close the horizontal cleavage extending up to the avascular zone. The hypothesis was that the clinical outcomes after open meniscal repair of horizontal tears are good with a low rate of secondary meniscectomy.


METHODS
Between 1998 and 2006, 28 patients (30 knees) underwent an open meniscal repair to treat symptomatic horizontal meniscal tears [6 women and 22 men, median age 25 years (16-44 years)]. The duration of symptoms was at least 12 weeks (12-72 weeks). Open meniscal repair was performed following arthroscopy. There were 14 medial and 7 lateral menisci, 10 grade 3 tears, and 11 grade 2 tears. If present (15 cases), meniscal cysts were removed using the same approach. Clinical outcomes were evaluated using KOOS and IKDC scores. The return to sporting activities and the need for a secondary meniscectomy were also assessed.


RESULTS
Twenty-one patients were evaluated at a median follow-up of 40 months (24-101 months). Twenty returned to their preinjury level of sporting activity. The median KOOS score was 92 ± 12.9. The median subjective IKDC score was 89 ± 14.1. There were four secondary meniscectomies.


CONCLUSIONS
Open meniscal repair of complex horizontal tears extending into the avascular zone was effective at midterm follow-up in young and active patients. The meniscus was preserved in 80 % of cases. Functional results deteriorated in those older than 30 years. This entity should be differentiated from degenerative meniscal tears that often occur in patients over 50, which may be associated with osteoarthritis.


METHODS
Retrospective study, Level IV.
Orthopedic Department, Centre Hospitalier de Versailles, Versailles-Saint Quentin University, 177, rue de Versailles, 78157 Le Chesnay, France. npujol@ch-versailles.fr
Nicolas
N
Pujol
Yohann
Y
Bohu
Philippe
P
Boisrenoult
Ali
A
Macdes
Philippe
P
Beaufils
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D020127:Recovery of Function; D013536:Suture Techniques; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome