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CLINICAL RESULTS OF ARTHROSCOPIC MENISCAL REPAIR – ARROWS VS. SUTURES



Abstract

This is a retrospective comparative review of the clinical results of arthroscopic meniscal repairs between the use of meniscal arrows and sutures. The study group consists of 37 repairs in 35 patients carried out by 2 special knee surgeons over a five-year period.

The arrow group consisted of 23 repairs in 21 patients. There were 14 males and 7 females. The medial meniscus was repaired in 13 and the lateral in 10 cases. Associated anterior cruciate ligament injured was present in 11 patients, of whom 9 underwent concomitant reconstruction along with the meniscal repair.

The suture group comprised 14 cases. Ten were male and 4 female. There were 8 medial meniscal repairs and 6 lateral.

The anterior cruciate was also torn in 8 cases, of whom 6 had it reconstructed. The repairs were carried out use #0-PDS by an out-to-in technique.

The 2 groups were grossly age and sex matched. Tears were located in zone 0/1, mainly in the posterior third segment of the meniscus. The rehabilitation protocol was similar in both groups. Minimum follow up was 9 months. Patients were evaluated by clinical review; questionnaire based on the Lysholm score and case record analysis. The overall clinical success rate for the arrows group was 13/23 (56.5%) compared to 11/14 (78.6%) for the suture group. Complications noted were broken arrows – 4 cases, cutaneous nerve entrapment by suture – 1, and delayed portal healing due to suture irritation – 1.

In conclusion, arthroscopic suture repair provided better clinical healing rates than meniscal arrows. Arrow breakage is a significant factor contributing to non-healing of initial tear repairs.

The abstracts were prepared by Wing Commander T. P. S. Bhullar. Correspondence should be addressed to him at the Ministry of Defence Hospital Unit, Edith Cavell Hospital, Bretton Gate, Peterborough PE3 9GZ.