clinical follow up of transosseous repair of root tears of the lateral meniscus
Author(s):
Driessen A. (Germany)
Driessen A. (Germany)
Affiliations:
ESSKA Academy. Driessen A. 05/09/18; 209732; P14-1884 Topic: Arthroscopic Surgery
Dr. Arne Driessen
Dr. Arne Driessen
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Abstract
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Objectives: An avulsion of the posterior tibial insertion of the lateral meniscus occurs during rotational distortion of the knee and can be associated with a tear of the anterior cruciate ligament (ACL). The diagnosis can easily be missed in initial radiological and arthroscopic assessment.
The purpose of this article was to report the technique and the outcome of surgical repair of lateral meniscus root tears.

Methods: We performed a follow up of 28 patients who, following anatomical ACL reconstruction using the ipsilateral semitendinosus graft, underwent either trans-osseous repair of the posterior lateral meniscus root (n=14) or no intervention (n=14). The meniscus root tears were classified as Forkel I lesions (posterior root tear, meniscofemoral ligament (MFL) intact). All patients were examined 6 months after surgery and undertook scoring using International Knee Documentation Committee Score (IKDC).

Results: Six months after surgery all patients had a negative pivot shift test and no difference of more than 3mm anterior translation on performing the instrumental laxity measurement.
Comparing the repair group with the no repair group the subjective IKDC 6 months after surgery was 75,72% (± 1,019) and 75,56 (± 1,058) respectively. Regarding the objective IKDC 8 x A (57,1%) and 6 x B (42,9%) could be ascertained in the repair group whereas 6 x A (42,9%), 6 x B (42,9%) and 2 x C (14,3%) scoring in the no repair group.

Conclusions: The use of the trans-osseous repair of root tears of the lateral meniscus in this small case series shows promising results. Despite the fact that the ACL reconstruction and the trans-osseous meniscal repair or no repair was not distinguishable from patient evaluation, in both groups patients restored a good and satisfying level of activity without obvious increase in complications or pain. It remains unclear if performing surgery on type Forkel I PLMRT and fixing it provides benefits compared to the nonsurgical procedures as in both healing and therefore stability might occur.

Keywords:
lateral meniscal root tear, transtibial meniscal refixation, meniscus repair, ACL injury, ACL reconstruction, clinical follow up,
Objectives: An avulsion of the posterior tibial insertion of the lateral meniscus occurs during rotational distortion of the knee and can be associated with a tear of the anterior cruciate ligament (ACL). The diagnosis can easily be missed in initial radiological and arthroscopic assessment.
The purpose of this article was to report the technique and the outcome of surgical repair of lateral meniscus root tears.

Methods: We performed a follow up of 28 patients who, following anatomical ACL reconstruction using the ipsilateral semitendinosus graft, underwent either trans-osseous repair of the posterior lateral meniscus root (n=14) or no intervention (n=14). The meniscus root tears were classified as Forkel I lesions (posterior root tear, meniscofemoral ligament (MFL) intact). All patients were examined 6 months after surgery and undertook scoring using International Knee Documentation Committee Score (IKDC).

Results: Six months after surgery all patients had a negative pivot shift test and no difference of more than 3mm anterior translation on performing the instrumental laxity measurement.
Comparing the repair group with the no repair group the subjective IKDC 6 months after surgery was 75,72% (± 1,019) and 75,56 (± 1,058) respectively. Regarding the objective IKDC 8 x A (57,1%) and 6 x B (42,9%) could be ascertained in the repair group whereas 6 x A (42,9%), 6 x B (42,9%) and 2 x C (14,3%) scoring in the no repair group.

Conclusions: The use of the trans-osseous repair of root tears of the lateral meniscus in this small case series shows promising results. Despite the fact that the ACL reconstruction and the trans-osseous meniscal repair or no repair was not distinguishable from patient evaluation, in both groups patients restored a good and satisfying level of activity without obvious increase in complications or pain. It remains unclear if performing surgery on type Forkel I PLMRT and fixing it provides benefits compared to the nonsurgical procedures as in both healing and therefore stability might occur.

Keywords:
lateral meniscal root tear, transtibial meniscal refixation, meniscus repair, ACL injury, ACL reconstruction, clinical follow up,
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