title: Arthroscopic repair of horizontal meniscal cleavage tears with marrow-stimulating technique.
abstract: OBJECTIVE
  The purpose of this study was to evaluate patients after arthroscopic repair of meniscal horizontal tears with a marrow-stimulating technique through clinical signs and second-look arthroscopy.
  
  
  METHODS
  We retrospectively reviewed a consecutive series of 32 meniscal repairs with horizontal cleavage tears and evaluated them through clinical assessment and second-look arthroscopic examinations. Arthroscopic meniscal repair and a marrow-stimulating technique were performed. Functional outcomes were evaluated using the visual analog scale (VAS) pain score, Lysholm knee scoring scale, and Tegner activity scale. Assessment of meniscal healing was evaluated clinically by the presence of meniscal signs; second-look arthroscopy was performed in 11 patients. Correlation between chronicity of a meniscal lesion (time from initial symptom [TFIS]) and meniscal healing was evaluated.
  
  
  RESULTS
  The mean follow-up period was 45.6 ± 13.9 months. Improvements in mean VAS scores from 6.7 to 1.9 (P < .001) were observed. The Lysholm score increased from 48.0 ± 14.4 to 92.0 ± 6.3 (P < .001). The Tegner activity score increased from 3.3 ± 1.1 to 6.8 ± 0.8 (P < .001). At the last follow-up, 29 of 32 patients (91%) were evaluated as healing in the clinical assessment. Of the 11 patients who underwent second-look arthroscopy, 8 (73%) showed complete healing, 2 (18%) had incomplete healing, and 1 (9%) failed to heal. Correlation between TFIS and meniscal healing was clinically significant (P = .001) but arthroscopically insignificant (P = .085) on second-look arthroscopy.
  
  
  CONCLUSIONS
  The meniscal repair procedure for horizontal cleavage tears in the present study suggests an alternative treatment option to approach the treatment of meniscal tears extending into the avascular zone and degenerative tissue. The marrow-stimulating technique using a cannulated reamer can be considered as an alternative method for the augmentation of meniscal healing.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Gyeonggi-do.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Orthopedic Surgery, Dongguk University Ilsan Hospital, Gyeonggi-do.
authors.forename: Oh-Jin
authors.initials: OJ
authors.lastname: Kwon
authors.affiliation: Department of Orthopedic Surgery, Hyun-Myoung Medical Center, Seoul, Korea. Electronic address: tsnam74@gmail.com.
authors.forename: Tae-Seok
authors.initials: TS
authors.lastname: Nam
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D001853:Bone Marrow / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D012421:Rupture / Q000473:pathology / Q000601:surgery; D024162:Second-Look Surgery / Q000379:methods; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D014945:Wound Healing; D055815:Young Adult