title: Time Interval between Trauma and Arthroscopic Meniscal Repair Has No Influence on Clinical Survival.
abstract: Arthroscopic meniscal repair is the gold standard for longitudinal peripheral meniscal tears. The time interval between trauma and meniscal repair remains controversial. The aim of this study was to evaluate failure rates and clinical outcome of arthroscopic meniscal repair in relation to chronicity of injury. A total of 238 meniscal repairs were performed in 234 patients. Anterior cruciate ligament (ACL) was reconstructed in almost all ACL-deficient knees (130 out of 133). Time interval between injury and repair was divided into acute (< 2 weeks), subacute (> 2 to < 12 weeks), and chronic (> 12 weeks). Patients completed postal questionnaires to evaluate clinical outcome and failure rates. Study instruments included Lysholm, Knee injury and Osteoarthritis Outcome Score (KOOS), and Tegner scoring systems. At a median follow-up of 41 months (interquartile range [IQR], 34-53 months) 55 medial and 10 lateral meniscal repairs failed (overall failure rate, 27%). There was a significant higher failure rate for medial meniscal repair (p < 0.05) and ACL-deficient knees without ACL reconstruction. Functional outcome scores showed only significant differences on the KOOS subscale "function in daily living" (95% confidence interval, 1.05-15.27, p < 0.05). No significant difference was found for any interval between trauma and repair. The interval between trauma and arthroscopic meniscal repair has no influence on the failure rate. Differences in survival rate of meniscal repair are more dependent on location of the lesion and ACL status, rather than chronicity of injury.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Medical Center Haaglanden, The Hague, The Netherlands.
authors.forename: Robert J P
authors.initials: RJ
authors.lastname: van der Wal
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Medical Center Haaglanden, The Hague, The Netherlands.
authors.forename: Bregje J W
authors.initials: BJ
authors.lastname: Thomassen
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Medical Center Haaglanden, The Hague, The Netherlands.
authors.forename: Jan-Willem A
authors.initials: JW
authors.lastname: Swen
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Medical Center Haaglanden, The Hague, The Netherlands.
authors.forename: Ewoud R A
authors.initials: ER
authors.lastname: van Arkel
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries / Q000601:surgery*; D061665:Time-to-Treatment; D016896:Treatment Outcome; D055815:Young Adult