Skip to main content
Erschienen in: International Orthopaedics 6/2020

28.01.2020 | Original Paper

Meniscus sutures by arthrotomy for a non-transfixing horizontal lesion associated with a cyst

verfasst von: Nicolas Girodano Orsini, Henri Favreau, David Eichler, Matthieu Ollivier, François Bonnomet, Matthieu Ehlinger

Erschienen in: International Orthopaedics | Ausgabe 6/2020

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Meniscal cysts are rare in Stoller grade II horizontal lesions. Several techniques are described in the literature for their management, without any real gold standard. The objective of this work was to report a series of meniscal sutures associated with cyst resection by arthrotomy. The hypothesis was that the results were satisfactory and comparable with the data in the literature regardless of the technique reported without morbidity added by arthrotomy.

Materials and methods

This was a monocentric retrospective study on 13 patients, aged 33 on average with a grade II meniscus lesion associated with a cyst (9 lateral and 4 medial menisci). Pre-operative data available was the VAS (5.7/10) and the Lysholm score (61/100). Primary endpoints were as follows: pain (visual analogue scale), global satisfaction, Lysholm functional score, and return to sports and professional activities at a minimum of two years. Secondary endpoints were complications, possible recurrence, and/or surgical revision. Recurrences, complications, and surgical recovery were gathered.

Results

Patients were evaluated with an average follow-up of 32 months. All patients were satisfied or very satisfied. The VAS significantly improved (0.2/10, p < 0.05) as well as the Lysholm score (97/100, p < 0.05). All patients returned to their professional activity: 11 within two months, one within six weeks, and one in the first post-operative week (this patient being a student). Only one patient did not resume pre-operative sport level due to a femoropatellar syndrome, not linked to the meniscal surgery performed. However, only 11 patients resumed their previous sport level (84.6%). No recurrence or surgical revision occurred.

Discussion

The results are good and similar to the literature, confirming the working hypothesis. These results are equivalent to partial meniscectomies and arthroscopic sutures associated with a procedure on the cyst by arthroscopy or arthrotomy. The literature is in favour of a procedure on the cyst.

Conclusion

The results confirm the effectiveness of a direct approach suture of non-transfixing meniscal lesions associated with a cyst resection with a good functional recovery, without additional morbidity. The hypothesis was confirmed.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Campbell SE, Sanders TG, Morrison WB (2001) MR imaging of meniscal cysts: incidence, location, and clinical significance. AJR Am J Roentgenol 177:409–413CrossRefPubMed Campbell SE, Sanders TG, Morrison WB (2001) MR imaging of meniscal cysts: incidence, location, and clinical significance. AJR Am J Roentgenol 177:409–413CrossRefPubMed
2.
Zurück zum Zitat Romanini L, Calvisi V, Collodel M, Masciocchi C (1988) Cystic degeneration of the lateral meniscus. Pathogenesis and diagnostic approach. Ital J Orthop Traumatol 14:493–500PubMed Romanini L, Calvisi V, Collodel M, Masciocchi C (1988) Cystic degeneration of the lateral meniscus. Pathogenesis and diagnostic approach. Ital J Orthop Traumatol 14:493–500PubMed
3.
Zurück zum Zitat Stoller DW, Martin C, Crues JV 3rd., Kaplan L, Mink JH (1987) Meniscal tears: pathologic correlation with MR imaging. Radiology 163:731–735CrossRefPubMed Stoller DW, Martin C, Crues JV 3rd., Kaplan L, Mink JH (1987) Meniscal tears: pathologic correlation with MR imaging. Radiology 163:731–735CrossRefPubMed
4.
Zurück zum Zitat Chen W, Zhao J, Wen Y et al (2015) Accuracy of 3-T MRI using susceptibility-weighted imaging to detect meniscal tears of the knee. Knee Surg Sports Traumatol Arthrosc 23:198–204CrossRefPubMed Chen W, Zhao J, Wen Y et al (2015) Accuracy of 3-T MRI using susceptibility-weighted imaging to detect meniscal tears of the knee. Knee Surg Sports Traumatol Arthrosc 23:198–204CrossRefPubMed
5.
Zurück zum Zitat Beaufils P, Becker R, Verdonk R, Aagaard H, Karlsson J (2015) Focusing on results after meniscus surgery. Knee Surg Sports Traumatol Arthrosc 23:3–7CrossRefPubMed Beaufils P, Becker R, Verdonk R, Aagaard H, Karlsson J (2015) Focusing on results after meniscus surgery. Knee Surg Sports Traumatol Arthrosc 23:3–7CrossRefPubMed
6.
Zurück zum Zitat Meserve BB, Cleland JA, Boucher TR (2008) A meta-analysis examining clinical test utilities for assessing meniscal injury. Clin Rehabil 22:143–161CrossRefPubMed Meserve BB, Cleland JA, Boucher TR (2008) A meta-analysis examining clinical test utilities for assessing meniscal injury. Clin Rehabil 22:143–161CrossRefPubMed
7.
Zurück zum Zitat Sommerlath KG (1991) Results of meniscal repair and partial meniscectomy in stable knees. Int Orthop 15:347–350CrossRefPubMed Sommerlath KG (1991) Results of meniscal repair and partial meniscectomy in stable knees. Int Orthop 15:347–350CrossRefPubMed
8.
Zurück zum Zitat Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49 Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
9.
Zurück zum Zitat Beaufils P, Hardy P, Chambat P et al (2006) Adult lateral meniscus. Rev Chir Orthop 92(5 Suppl):2S169–2S194PubMed Beaufils P, Hardy P, Chambat P et al (2006) Adult lateral meniscus. Rev Chir Orthop 92(5 Suppl):2S169–2S194PubMed
10.
Zurück zum Zitat Yulish BS, Montanez J, Goodfellow DB et al (1987) Chondromalacia patella : assessment with MR imaging. Radiology 164:763–766CrossRefPubMed Yulish BS, Montanez J, Goodfellow DB et al (1987) Chondromalacia patella : assessment with MR imaging. Radiology 164:763–766CrossRefPubMed
11.
Zurück zum Zitat Hulet C, Souquet D, Alexandre P, Locker B, Beguin J, Vielpeau C (2004) Arthroscopic treatment of 105 lateral meniscal cysts with 5-year average follow-up. Arthroscopy 20:831–836CrossRefPubMed Hulet C, Souquet D, Alexandre P, Locker B, Beguin J, Vielpeau C (2004) Arthroscopic treatment of 105 lateral meniscal cysts with 5-year average follow-up. Arthroscopy 20:831–836CrossRefPubMed
12.
Zurück zum Zitat Bombaci H, Kuyumcu M, Coskun T, Kaya E (2016) When should the external approach be resorted to in the arthroscopic treatment of perimeniscal cyst ? SICOT J 20:19CrossRef Bombaci H, Kuyumcu M, Coskun T, Kaya E (2016) When should the external approach be resorted to in the arthroscopic treatment of perimeniscal cyst ? SICOT J 20:19CrossRef
13.
Zurück zum Zitat Dai PY, Tan HL, Yuan YH, Li XY (2018) Arthroscopic cyst removal and wire-guided suture for the treatment of lateral meniscal cyst of knee joint. Zhongguo Gu Shang 31:944–948PubMed Dai PY, Tan HL, Yuan YH, Li XY (2018) Arthroscopic cyst removal and wire-guided suture for the treatment of lateral meniscal cyst of knee joint. Zhongguo Gu Shang 31:944–948PubMed
14.
Zurück zum Zitat Chen D, Li Q, Sun Y, Qin J, Yao Y, Jiang Q (2017) Arthroscopic management for the unstable inferior leaf of the lateral meniscus anterior horn and associated cysts through a direct inframeniscal portal: a retrospective study. Biomed Res Int 2017:9264907PubMedPubMedCentral Chen D, Li Q, Sun Y, Qin J, Yao Y, Jiang Q (2017) Arthroscopic management for the unstable inferior leaf of the lateral meniscus anterior horn and associated cysts through a direct inframeniscal portal: a retrospective study. Biomed Res Int 2017:9264907PubMedPubMedCentral
15.
Zurück zum Zitat Reagan WD, McConkey JP, Loomer RL, Davidson RG (1989) Cysts of the lateral meniscus: arthroscopy versus arthroscopy plus open cystectomy. Arthroscopy 5:274–281CrossRefPubMed Reagan WD, McConkey JP, Loomer RL, Davidson RG (1989) Cysts of the lateral meniscus: arthroscopy versus arthroscopy plus open cystectomy. Arthroscopy 5:274–281CrossRefPubMed
16.
Zurück zum Zitat Glasgow MM, Allen PW, Blakeway C (1993) Arthroscopic treatment of cysts of the lateral meniscus. J Bone Joint Surg Br 75B:299–302CrossRef Glasgow MM, Allen PW, Blakeway C (1993) Arthroscopic treatment of cysts of the lateral meniscus. J Bone Joint Surg Br 75B:299–302CrossRef
17.
Zurück zum Zitat Calvisi V, Preite R, Romanini L (1989) Cystic degeneration of the external meniscus. Part 2: arthroscopic meniscectomy. Ital J Orthop Traumatol 15:33–41PubMed Calvisi V, Preite R, Romanini L (1989) Cystic degeneration of the external meniscus. Part 2: arthroscopic meniscectomy. Ital J Orthop Traumatol 15:33–41PubMed
18.
Zurück zum Zitat Kumar NS, Jakoi AM, Swanson CE, Tom JA (2014) Is formal decompression necessary for parameniscal cysts associated with meniscal tear ? Knee 21:501–503CrossRefPubMed Kumar NS, Jakoi AM, Swanson CE, Tom JA (2014) Is formal decompression necessary for parameniscal cysts associated with meniscal tear ? Knee 21:501–503CrossRefPubMed
19.
Zurück zum Zitat Sarimo J, Rainio P, Rantanen J, Orava S (2002) Comparison of two procedures for meniscal cysts. A report of 35 patients with a mean follow-up of 33 months. Am J Sports Med 30:704–707CrossRefPubMed Sarimo J, Rainio P, Rantanen J, Orava S (2002) Comparison of two procedures for meniscal cysts. A report of 35 patients with a mean follow-up of 33 months. Am J Sports Med 30:704–707CrossRefPubMed
20.
Zurück zum Zitat Beaufils P, Pujol N (2018) Meniscal repair: technique. Orthop Traumatol Surg Res 104:S137–S145CrossRefPubMed Beaufils P, Pujol N (2018) Meniscal repair: technique. Orthop Traumatol Surg Res 104:S137–S145CrossRefPubMed
21.
Zurück zum Zitat Pujol N, Bohu Y, Boisrenoult P, Macdes A, Beaufils P (2013) Clinical outcomes of open meniscal repair of horizontal meniscal tears in young patients. Knee Surg Sports Traumatol Arthrosc 21:1530–1533CrossRefPubMed Pujol N, Bohu Y, Boisrenoult P, Macdes A, Beaufils P (2013) Clinical outcomes of open meniscal repair of horizontal meniscal tears in young patients. Knee Surg Sports Traumatol Arthrosc 21:1530–1533CrossRefPubMed
22.
Zurück zum Zitat Biedert RM (2000) Treatment of intrasubstance meniscal lesions : a randomized prospective study of four different methods. Knee Surg Sports Traumatol Arthrosc 8:104–108CrossRefPubMed Biedert RM (2000) Treatment of intrasubstance meniscal lesions : a randomized prospective study of four different methods. Knee Surg Sports Traumatol Arthrosc 8:104–108CrossRefPubMed
23.
Zurück zum Zitat Pujol N, Tardy N, Boisrenoult P, Beaufils P (2015) Long-term outcomes of all-inside meniscal repair. Knee Surg Sports Traumatol Arthrosc 23:219–224CrossRefPubMed Pujol N, Tardy N, Boisrenoult P, Beaufils P (2015) Long-term outcomes of all-inside meniscal repair. Knee Surg Sports Traumatol Arthrosc 23:219–224CrossRefPubMed
24.
Zurück zum Zitat Lozano J, Ma CB, Cannon WD (2007) All-inside meniscus repair: a systematic review. Clin Orthop Relat Res 455:134–141CrossRefPubMed Lozano J, Ma CB, Cannon WD (2007) All-inside meniscus repair: a systematic review. Clin Orthop Relat Res 455:134–141CrossRefPubMed
25.
Zurück zum Zitat Nepple JJ, Dunn WR, Wright RW (2012) Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am 94A:2222–2227CrossRef Nepple JJ, Dunn WR, Wright RW (2012) Meniscal repair outcomes at greater than five years: a systematic literature review and meta-analysis. J Bone Joint Surg Am 94A:2222–2227CrossRef
26.
Zurück zum Zitat Cassard X, Verdonk R, Almqvist KF et al (2004) Meniscal repair. Rev Chir Orthop Reparatrice Appar Mot 90(8 Suppl):3S49–3S75PubMed Cassard X, Verdonk R, Almqvist KF et al (2004) Meniscal repair. Rev Chir Orthop Reparatrice Appar Mot 90(8 Suppl):3S49–3S75PubMed
Metadaten
Titel
Meniscus sutures by arthrotomy for a non-transfixing horizontal lesion associated with a cyst
verfasst von
Nicolas Girodano Orsini
Henri Favreau
David Eichler
Matthieu Ollivier
François Bonnomet
Matthieu Ehlinger
Publikationsdatum
28.01.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 6/2020
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-020-04491-3

Weitere Artikel der Ausgabe 6/2020

International Orthopaedics 6/2020 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.