Introduction
Blood supply
Meniscal tear patterns
Extent of tear
Authors | No. of patients | Mean age (years) | Mean FU | ACL | Zone | MM/LM | Time from injury to repair | Technique | Evaluation method | Outcome |
---|---|---|---|---|---|---|---|---|---|---|
Rubman [16] | 177 | 28 | 42 months (18 months arthroscopically) | 128 ACL rupture (126 reconstruction) | R–W | 106 MM 92 LM | Inside-out | 161 clinical examination 91 Arthroscopy | 20% required repeat arthroscopy Of 91 arthroscopy 58% further meniscal surgery | |
Noyes [18] | 29 | 16.8 (10.1–21.9) | 16.8 year | 24 ACL reconstruction | R–W | 11 MM 18 LM | 31 weeks | Inside-out vertical divergent sutures | 6 meniscectomies 2 early onset OA 3 failed on MRI | |
Gallacher [17] | 87 73 M 14 F | 26 (13–54) | 12 months (13–115) | Intact | W–W | 50 MM 37 LM 3 PT 84 FTT 69 BHT 14 PHT | 8 months (1 week–10 years) | All-inside Clear fix (72) FasT-fix sutures (13) Both (2) | Lysholm 61 → 75 Tegner 6 → 6 8 re-repairs 20 meniscectomies LM = MM outcomes | |
Noyes [21] | 29 23 M 6 F | 45 | 33 months | 21 ACL reconstruction | R–W 4 mm RW | 19 MM 11 LM | 10 < 10 weeks from injury 19 > 10 weeks from injury | Inside-out suture repair | 3 partial meniscectomy |
Patients age
Chronicity
Associated ACL injury
Indications and contraindications
Patient factors | Tear characteristics |
---|---|
Younger (< 40), active patient | Red–red/red–white—ideal but not mandatory |
No significant comorbidities | Simple tear pattern |
BMI < 30 | < 3 months old |
Willingness to comply with post-operative rehabilitation regime | Associated ACL reconstruction |
Reducible without excess tension | |
Lower threshold for complete radial tears |
Surgical repair
Open
Authors | No. of patients | Mean age (years) | Mean FU (years) | ACL | Zone | MM/LM | Time from injury to repair | Evaluation method | Outcome |
---|---|---|---|---|---|---|---|---|---|
DeHaven [52] | 30 | 18.9 | 10.9 | 15 ACLR | R–R | 23 MM 10 LM | Clinical | 21% re-tear | |
Muellner [38] | 22 | 32.2 | 12.9 | 7 ACLR | 18 MM 5 LM | 8.7 days | Radiographs MRI | 9% re-tear 27% degenerative changes | |
Rockborn [27] | 31 | 25 | 13 | All intact | 17 MM 14 LM | 13.5 weeks | Clinical Radiographs | 29% re-tear |
Arthroscopic-assisted inside-out and outside-in techniques
All-inside
Authors | No. of patients | Mean age (years) | Mean FU | ACL | Zone | MM/LM | Time from injury to repair | Implant | Evaluation method | Outcome |
---|---|---|---|---|---|---|---|---|---|---|
Jones [28] | 38 | 29.9 | 29.7 months | 22 ACLR | R–R 77% R–W 19.4% W–W 2.8% | 33 MM 6 LM | 5.9 months | Meniscus Arrow | Telephone questionnaire | 2 partial meniscectomy 31.6% local irritative symptoms 2 removal of fragments |
Gill [29] | 32 | 2.3 years | 16 acute < 6 weeks 23 chronic > 6 weeks | Meniscus Arrow | Clinical | 9.4% failure rate 3 partial meniscectomy | ||||
Lee [30] | 32 | 6.6 years | 32 ACLR | Meniscus Arrow | 28.6% failure rate | |||||
Siebold [53] | 95 | 30 | 6 years | 63 ACLR | RR R–W | 77 MM 18 LM | 3 months | Meniscus Arrow | Clinical | 28% meniscectomy ACL had no effect Lysholm 64 → 90.5 |
Kurzweil [54] | 57 | 27 | 54 months | 42 ACLR | Meniscus Arrow | 2nd look arthroscopy and MRI | 28% failure rate | |||
Kotsovolos [32] | 58 37 M 21 F | 32.6 | 18 months | 36 ACLR | RR 36% R–W 64% | 34 MM 27 LM | 76 days | FasT-Fix | Clinical | 9.8% failure Lysholm 43.6 → 87.5 4 stiff knee |
Barber [55] | 41 25 M 11 F | 28 | 30.7 months | 29 ACLR | R–R 37% R–W 63% | 26 MM 15 LM | 13 weeks | FasT-Fix | Clinical | Lysholm 47.3 → 87.4 17% meniscectomy |
Tachibana [34] | 46 20 M 26 W | 26.5 | 14 months | 46 ACLR | R–R 34 R–W 28 | 28 MM 34 LM | 37 months | FasT-Fix | 2nd Look arthroscopy | |
Konan [51] | 288 | 32 | 18 months | 138 ACLR | 171 LM 141 MM | 54 Meniscus Arrow 258 FasT-Fix | Clinical ± MRI if clinical doubt | 22.2% failure rate Meniscus Arrow 10.3% failure rate FasT-Fix 3 painful capsular sutures requiring removal |