Arthroscopic all-inside meniscal repair—Does the meniscus heal?

Abstract

ObjectiveThe purpose of this study was to correlate clinical and radiological results using a 3-T MRI to verify meniscal healing after
arthroscopic all-inside meniscus repair.

Materials and methodsWe selected 27 patients (14 men and 13 women) with an average age of 31 ± 9years and retrospective clinical examinations
and radiological assessments using a 3-T MRI after all-inside arthroscopic meniscal repair were conducted. Repair of the medial
meniscus was performed in 19 patients and of the lateral meniscus in eight. In 17 patients (63%), we performed concomitant
anterior cruciate ligament reconstruction. The mean follow-up period was 4.5 ± 1.7years. The Lysholm score and Tegner activity
index were used for clinical evaluation. Four grades were used to classify the radiological signal alterations within the
meniscus: central globular (grade 1); linear horizontal or band-like (grade 2); intrameniscal alterations and linear signal
alterations communicating with the articular surface (grade 3); and complex tears (grade 4).

ResultsAt follow-up, the average Lysholm score was 76 ± 15 points, with ten of the patients placed in group 6 based on the Tegner
activity index. MRI examinations revealed no signal alteration in three patients, grade 1 in 0, grade 2 in five, grade 3 in
13, and grade 4 in six. The MRI findings correlated positively with the clinical scores in 21 patients (78%).

ConclusionsCorrelation of clinical and radiological examination was performed using 3-T MRI. In spite of satisfactory clinical outcomes
at follow-up, a radiological signal alteration may still be visible on MRI, which was believed to be scar tissue, but could
not be proven definitively. Imaging with a 3-Tesla MRI after meniscal suture surgery provides good but no definitive reliability
on meniscus healing and therefore gives no advantage compared to 1.5-T MRI, with good clinical outcome using an all-inside
arthroscopic meniscal repair.

Clinical relevance3T-MRI can not substitute diagnostic arthroscopy in patients with persistent complaints after arthroscopic all-inside meniscal
repair.

Level of evidenceRetrospective case series (EBM Level IV)

Keywords3-T MRI-Arthroscopy-Meniscal suture-All-inside repair technique-FasT-Fix Device