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Second look arthroscopic assessment of medial meniscal repair combined with around the knee osteotomies
Author(s):
Tsukamoto H. (Japan)
Tsukamoto H. (Japan)
Affiliations:
ESSKA Academy. Tsukamoto H. 05/09/18; 209781; P15-394 Topic: Arthroscopic Surgery
Dr. Hiroaki Tsukamoto
Dr. Hiroaki Tsukamoto
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Abstract
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Objectives: Meniscal repair with fibrin clot for degenerative meniscal tear in elderly enhances meniscal healing potential and has good clinical results. However, varus deformity is one of poor prognostic factors. It is expected that unloading mechanical stress will promote meniscal potential. Therefore, in this study, we investigated meniscal healing status in second look arthroscopy findings for medial meniscal repair combined with around the knee osteotomies.

Methods: Of the 53 patients who underwent around the knee osteotomies between October 2012 and April 2017, 15patients 16knees who were undergone medial meniscal repair without fibrin clot and second look arthroscopy when plate was removed. Average age 64.2 years old, average plate removal periods were 16 months.
Based on deformity analysis, Osteotomies were performed targeting intra-operative %MA to be 62%. The meniscus repair was performed in all cases by the inside-out technique. The healing status of the medial meniscus at the time of plate removal was divided into three stages of complete, incomplete, and failure, and the changes of %MA between before and after operation was used for evaluation on meniscal healing status.

Results: Complete healing was observed at 9 knees in 9 knees, and when combined with incomplete healing, meniscal adhesion rate was 87%. When %MA after operation was less than 50, there were no cases complete healing, In all cases above %MA 50 after operation, complete or incomplete healing were obtained.

Conclusions: Unloading medial compartment with around the knee osteotomies promotes meniscal healing potential.

Keywords:
meniscal repair, degenerative meniscal tear, around the knee osteotomies, healing potential
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