title: Meniscus suture repair: minimum 10-year outcomes in patients younger than 40 years compared with patients 40 and older.
abstract: BACKGROUND
  Few studies have compared outcomes after meniscus suture repair in patients younger than 40 years versus patients 40 years and older.
  
  
  OBJECTIVE
  To document failure rates and long-term outcomes after meniscus suture repair by a single surgeon, using the inside-out technique, at a minimum 10-year follow-up in patients younger than 40 years versus those 40 years and older.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  This study included all patients 18 years or older who underwent meniscus suture repair with the inside-out technique by a single surgeon between January 1992 and December 2003. Patients were divided into 2 cohorts according to age: <40 years (cohort 1) and ≥40 years (cohort 2). If patients underwent subsequent knee surgery, all subsequent reports, whether performed by the original treating surgeon or by a different surgeon elsewhere, were reviewed by 2 independent reviewers not involved in the primary care of the patients. Reviewers classified surgeries as failures if the subsequent surgery treated the same area of the meniscus as repaired in the index surgery. Patients completed a subjective questionnaire at minimum of 10 years after arthroscopy. Outcomes measures included Lysholm, Tegner, and patient satisfaction with outcome. All data were collected prospectively.
  
  
  RESULTS
  The surgeon performed 339 meniscus repairs between 1992 and 2003. The study included 181 knees in 178 patients, who had a mean age of 33 years (range, 18-70 years). Cohort 1 contained 136 knees; 16 patients (12%) were lost to follow-up and 47 (35%) underwent a subsequent knee arthroscopy. Cohort 2 contained 45 knees; 2 patients (4.4%) were lost to follow-up, 3 patients had a total knee arthroplasty, and 12 patients (28%) underwent a subsequent knee arthroscopy. In cohort 1, the meniscus repair failure rate was 5.5% (6/110), and in cohort 2 it was 5.3% (2/38) (P = .927). There was no significant difference in failure rate based on which meniscus was repaired (P = .257), concomitant anterior cruciate ligament (ACL) reconstruction (P = .092), or microfracture (P = .674). Average follow-up time for cohort 1 was 16.1 years (range, 10.0-21.9 years), with 82% follow-up (n = 73/89); average follow-up time for cohort 2 was 16.2 years (range, 10.1-21.0 years), with 93% follow-up (n = 28/30). There were no significant differences in outcomes scores after meniscus suture repair based on age cohort or meniscus side, presence of an ACL tear, or concomitant microfracture procedure.
  
  
  CONCLUSIONS
  Meniscus repair failure rate was not different in patients who were younger than 40 years versus those who were 40 years or older at time of meniscus index surgery. Patients who underwent meniscus suture repair had high function and high patient satisfaction at an average of 16 years after meniscus suture repair, and no differences were seen based on age.
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: J Richard
authors.initials: JR
authors.lastname: Steadman
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Matheny
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Singleton
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Johnson
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: William G
authors.initials: WG
authors.lastname: Rodkey
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Crespo
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA Karen.briggs@sprivail.org.
authors.forename: Karen K
authors.initials: KK
authors.lastname: Briggs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059549:Anterior Cruciate Ligament Reconstruction; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D059012:Lost to Follow-Up; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D013537:Sutures; D017211:Treatment Failure; D014945:Wound Healing / Q000502:physiology
keywords: meniscus suture repair; outcomes; over 40 years old; revision