Abstract
Purpose of study: The all inside fixation of meniscal tears with bio-degradable products is popular because of its fast application and reduction in risks of serious neurovascular complications. We reviewed the results of a consecutive series of all inside meniscal repairs performed by the senior author in a carefully selected patient population.
Materials & Results: The senior author performed 104 consecutive meniscal repairs (54 lateral & 50 medial meniscus) in 96 patients (66 male, 30 female), using all inside meniscal repair systems (18 Bionxx, 86 FasT Fix; Smith & Nephew). The average patient age at the time of repair was 31.6 years (range 17 – 46 years). On an average 2 arrows (range 1–4) were used in the Bionnx system and 2.5 sutures (range 1–7) for the Fas T fix system. The predominant tear pattern was a peripheral red on white type tear involving the body and posterior horn. Concomitant ACL reconstruction was undertaken in 50% cases. In 26.9 % cases the repaired meniscus was partially trimmed prior to repair and in 25 % cases a tear of the non repaired meniscus was stabilised by trimming alone. A further arthroscopic partial menisectomy was performed in 12 cases of failed repair (4 Bionxx, 8 Fas T fix) at an average of 16.16 months (range 1 month – 44 months). None of the other patients had symptoms or signs suggestive of meniscal pathology on follow up (minimum 12 months). The repair was successful in 90.69 % of Fas T fix repairs and 77.78 % of Bionxx repairs. The meniscal repair failure rate in the group which had an ACL reconstruction was 5.77 %. No major intra or post operative complications were noted.
Conclusion: Successful meniscal preservation is feasible by using an all-inside meniscal repair device. Patient selection and due consideration to the site and geometry of the meniscal tear is crucial.
Correspondence should be addressed to Mr T Wilton, c/o BOA, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
