Abstract
Arthroscopic meniscal repair is still the subject of discussion. The first meniscal repair was performed by Hannandale in 1883 and the first arthroscopic repair by Ikeuchi in 1969. Today, arthroscopic meniscal repair is easy to perform, thanks to the many kind of devices in use. However, even though some colleagues such as Dehaven and Morgan report 20 years of experience, many others do not perform this type of procedure.
The purpose of this paper is to report our experience with two different techniques for all-inside repair; Linvatec Suture Hook and Smith-Nephew Fast Fix device. Since May 2001 we have performed 41 arthroscopic meniscal repair procedures (23 with the Fast-Fix device) in young people with a recent mural lesion, with no axial defect, with or without combined anterior cruciate ligament (ACL) reconstruction.
The post-operative rehabilitation consisted in 15 days of isotonic and isometric physiotherapy without weight bearing; after this period progressive weight bearing is allowed to improve muscle.
Patients operated for meniscal repair only can resume work after 30–40 days and take up sport activity after 50–60 days. Patients with both meniscal repair and ACL reconstruction performed a standard rehabilitation protocol for ACL reconstruction and get back to sports such as swimming after 3 months and football after 6 months.
We did have a patient with swelling and pain for 60 days after operation but which disappeared spontaneously after this period, and we have a patient who, after 11 months, still has persistent pain in the posterior compartment with a loosening 10° of flexion without synovitis or any other kind of complication.
We consider the suture hook device very useful, but difficult to use in small knees with very posterior lesions, and in which an accessory arthroscopic portal is often required. Fast-Fix devices allow fast repair and are also easy to use in posterior horn lesions, but they are non-absorbable and thus care must be taken to avoid errors in technique, with the risk of loosening the darts in the joint. They are also much more expensive.
In conclusion, both techniques are useful for meniscal repair and both can be used alone or together, depending on the lesions.
