Abstract
Hypothesis
Avascular meniscal tears can be repaired with good clinical outcomes.
Background
The mechanical disadvantage and detrimental effect to articular cartilage following meniscectomy has been well documented in the literature. Meniscal repair in the avascular (white on white zone) is controversial and would be deemed inappropriate by many.
Methods
Between 1999 and 2008 our department prospectively collected data on all meniscal repairs as part of a sports injury database. 423 patients underwent meniscal repair at our unit during this time period. We identified 88 patients who underwent a meniscal repair of a non peripheral tear (white on white zone) where there was no co-existent ACL injury or instability. There were 74 males and 14 females with a mean age of 26 years (13-54). There were 50 medial meniscal tears and 38 lateral tears, all in the non peripheral area of the meniscus. The criterion for failure was any reoperation on the same meniscus requiring excision or re fixation.
Results
The mean follow up was 44 months (5–106). Twenty nine patients required further surgery on their repaired meniscus. There were nine re-repairs and twenty partial menisectomies. Of the nine re-repairs only one has gone on to have a further procedure with meniscectomy. This represents a success rate of 67% (59/88). The mean pre-operative Lysholm score was 61 (4-88) which rose to 75 (12-100) postoperatively, (p=0.002). The mean pre-operative Tegner score was 6 (3-10) and this did not change significantly post operatively, mean 6 (0-10) (p=0.4).
Conclusions
Isolated white on white avascular meniscal tears can be successfully repaired in the majority of cases with a good clinical and functional result.
