Arthroscopic Repair of Meniscal Tears Extending into the Avascular Zone in Patients Younger Than Twenty Years of Age

Background: Limited data are available regarding repair results of meniscal tears extending into the central avascular region. Hypothesis: Meniscal tears extending into the avascular region can be successfully repaired in patients less than 20 years old. Study Design: Prospective cohort study. Metho...

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Bibliographic Details
Published in:The American journal of sports medicine 2002-07, Vol.30 (4), p.589-600
Main Authors: NOYES, Frank R, BARBER-WESTIN, Sue D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Arthroscopy
Biological and medical sciences
Blood vessels
Child
Endoscopic surgery
Female
Humans
Injuries
Joints
Knee
Knee Injuries - surgery
Male
Medical sciences
Menisci, Tibial - surgery
Meniscus (Anatomy)
Orthopedic Procedures
Orthopedic surgery
Prospective Studies
Reconstructive Surgical Procedures
Reoperation
Rupture - surgery
Sports medicine
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Suture Techniques
Tibial Meniscus Injuries
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Summary:Background: Limited data are available regarding repair results of meniscal tears extending into the central avascular region. Hypothesis: Meniscal tears extending into the avascular region can be successfully repaired in patients less than 20 years old. Study Design: Prospective cohort study. Methods: We examined the results of 71 meniscal repairs (64 knees) for tears extending into the central avascular region in patients 19 years of age or younger; 67 were examined clinically (mean, 51 months after surgery) and 36, by follow-up arthroscopy (mean, 18 months). Results: In 53 of 71 (75%) meniscal repairs patients had no tibiofemoral compartment symptoms and there were no clinical failures. In 18 (25%) meniscal repairs, patients showed tibiofemoral symptoms or a failed repair was detected on follow-up arthroscopy. In the subgroup of 45 knees with meniscal repair and anterior cruciate ligament reconstruction evaluated clinically, 39 (87%) patients rated their knee as normal or very good, 2 (4%) as good, 3 (7%) as fair, and 1 (2%) as poor. Conclusions: A stable repair of complex meniscal tears that extend into the avascular region can be obtained using a meticulous inside-out vertical divergent suture technique. We recommend repair, particularly in young active patients in whom removal of complex tears would result in major loss of meniscal function and the risk of future arthrosis.
ISSN:0363-5465
1552-3365
DOI:10.1177/03635465020300042001