Meniscal repair offers the potential to avoid the long-term articular cartilage deterioration that has been shown to result after meniscectomy. Failure of the meniscal repair can occur several years postoperatively. Limited evidence on the long-term outcomes of meniscal repair exists.
We performed a systematic review of studies reporting the outcomes of meniscal repair at a minimum of five years postoperatively. Pooling of data and meta-analysis with a random-effects model were performed to evaluate the results.
Thirteen studies met the inclusion criteria. The pooled rate of meniscal repair failure (reoperation or clinical failure) was 23.1% (131 of 566). The pooled rate of failure varied from 20.2% to 24.3% depending on the status of the anterior cruciate ligament (ACL), the meniscus repaired, and the technique utilized. The rate of failure was similar for the medial and the lateral meniscus as well as for patients with an intact and a reconstructed ACL.
A systematic review of the outcomes of meniscal repair at greater than five years postoperatively demonstrated very similar rates of meniscal failure (22.3% to 24.3%) for all techniques investigated. The outcomes of meniscal repair at greater than five years postoperatively have not yet been reported for modern all-inside repair devices.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
" to heal . Laible et al . reported an improved healing response in younger patients following meniscal repair ( Laible et al . , 2013 ) . In the event that a ligamentous ( e . g . , ACL ) injury has occurred con - comitantly with the meniscal tear , it is recommended that reconstruction be performed to improve func - tional stability of the knee ( Nepple et al . , 2012 ) . Meniscal repair in conjunction with ACL reconstruc - tion , orthopaedic surgeons can expect an estimated >90% clinical success rate at 2 - year follow - up ( War - ren , 1990 ; Cannon and Vittori , 1992 ; Guisasola et al . , 2002 ; Pujol et al . , 2008 ; Pujol and Beaufils , 2009 ; Toman et al . , 2009 ; Ghodadra et al . , 2012 ; Fu"
[Show abstract][Hide abstract] ABSTRACT: Meniscal tears are relatively common injuries sustained by athletes and non-athletes alike and have far reaching functional and financial implications. Studies have clearly demonstrated the important biomechanical role played by the meniscus. Long-term follow-up studies of post-menisectomy patients show a predisposition toward the development of degenerative arthritic changes. As such, substantial efforts have been made by researchers and clinicians to understand the cellular and molecular basis of meniscal healing. Proinflammatory cytokines have been shown to have a catabolic effect on meniscal healing. In vitro and some limited in vivo studies have shown a proliferative and anabolic response to various growth factors. Surgical techniques that have been developed to stimulate a healing response include mechanical abrasion, fibrin clot application, growth factor application, and attempts at meniscal neovascularization. This article discusses various augmentation techniques for meniscal repair and reviews the current literature with regard to fibrin clot, platelet rich plasma, proinflammatory cytokines, and application of growth factors.
Current Reviews in Musculoskeletal Medicine 03/2013; 6(2). DOI:10.1007/s12178-013-9165-z
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