title: Combined outside-in and FasT-Fix sutures for the treatment of serious discoid meniscal tears: A midterm follow-up study.
abstract: BACKGROUND
  The treatment of discoid meniscus is debatable. This study aimed to assess the clinical efficacy of combined outside-in and FasT-Fix sutures for the treatment of serious discoid meniscal tears.
  
  
  METHODS
  This study included 32 consecutive patients who underwent arthroscopic meniscal plasty for serious discoid meniscal tears (full-thickness vertical, longitudinal tears >10mm) between October 2006 and June 2012. A combination of outside-in and FasT-Fix sutures was used to treat serious discoid meniscal tears. Disappearance of clinical symptoms (locked knee, pain, and clicking) and negative results in the McMurray and Apley grind tests were assessed during follow-up (26 to 47months). The Lysholm, IKDC, and Tegner scores were assessed for therapeutic efficacy. Some patients were followed up with MRI.
  
  
  RESULTS
  Symptoms (pain, clicking, and locking) disappeared in all patients. The Lysholm score improved from 39.1±9.2 to 89.6±6.7 at six months, and to 90.1±6.3 at the last follow-up. The same trends were observed for the IKDC score (from 38.0±9.5 to 90±6.3, and to 91.1±6.4) and the Tegner score (from 2.8±0.6 to 5.2±0.6, and to 5.2±0.5). Among all patients, 13 were followed up with MRI. Among these patients, four had an unhealed stitched edge, but they did not complain of any discomfort in the knees.
  
  
  CONCLUSIONS
  The use of a combination of outside-in and FasT-Fix sutures for meniscal plasty had good outcomes for serious discoid meniscal tears and can thus be regarded as a good surgical option.
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
authors.forename: Yuezheng
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
authors.forename: Xinxian
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
authors.forename: Huachen
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China. Electronic address: huzhengyue2014@126.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Wen
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D013537:Sutures; D000070600:Tibial Meniscus Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthroscope; Discoid meniscus; FasT-Fix; Outside-in suture