Abstract
Introduction
This retrospective study presents clinical patient outcomes following meniscal repair using T-Fix devices and a modifiable, progressive rehabilitation program.
Materials and methods
Fifty-two patients (35 males and 17 females) with a mean age of 26.7 years (range 13–50 years) representing all of the patients who underwent arthroscopic meniscal repair (43 medial meniscus, 12 lateral meniscus) over a 3-year period by the same surgeon (D.C.) (55 menisci) participated in this study. Thirty-two of the patients (62%) had an associated ACL tear. All patients with an ACL tear underwent reconstruction (tibialis anterior allograft) at the time of meniscal repair. All meniscal tears were located in either the red-red zone (29) or the red-white zone (26). All patients who underwent meniscal repair participated in a modifiable (based on meniscal tear size, type, and location) progressive rehabilitation program. Operative notes and photographs were reviewed to identify the meniscal tear location, tear type, tear length, and the number of T-Fix devices used. Orthopedic clinic and physical therapy reports were also reviewed for postoperative range of motion, knee joint effusion, knee joint pain, McMurray test findings, and single-leg broad-jump test performance (90% bilateral equivalence goal). The average postoperative clinical follow-up period was 10.3 months (range 4–24 months).
Results
Most (22/23, 96%) patients who underwent meniscal repair alone displayed excellent results. All patients (32/32, 100%) who underwent combined ACL reconstruction-meniscal repair displayed excellent results. During an acute event such as a sudden directional change while running or contact with another player, 5 of these patients re-injured their meniscus at the repair site in conjunction with tearing the reconstructed ACL at 12±3 months following the index surgical procedure. Each of these 1–2 cm meniscal tears had been previously repaired with two T-Fix devices.
Conclusion
The T-Fix device used in combination with a modifiable progressive rehabilitation program produced excellent clinical patient outcomes among this patient group.
Similar content being viewed by others
References
Arnoczky SP, Warren RF (1983) The microvasculature of the meniscus and its response to injury. An experimental study in the dog. Am J Sports Med 11:131–141
Asik M, Sen C, Erginsu M (2002) Arthroscopic meniscal repair using T-fix. Knee Surg Sports Traumatol Arthrosc 10:284–288
Asik M, Sener N (2002) Failure strength of repair devices versus meniscus suturing techniques. Knee Surg Sports Traumatol Arthrosc 10:25–29
Austin KS, Sherman OH (1993) Complications of arthroscopic meniscal repair. Am J Sports Med 21:864–868
Barber FA (1994) Accelerated rehabilitation for meniscus repairs. Arthroscopy 10:206–210
Barber FA, Click SD (1997) Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction. Arthroscopy 13:433–437
Barber FA, Herbert MA (2000) Meniscal repair devices. Arthroscopy 16:613–618
Barber FA, Herbert MA (1999) Suture anchors--update 1999. Arthroscopy 15:719–725
Barrett GR, Treacy SH, Ruff CG (1997) Preliminary results of the T-fix endoscopic meniscus repair technique in an anterior cruciate ligament reconstruction population. Arthroscopy 13:218–223
Becker R, Schroder M, Starke C, Urbach D, Nebelung W (2001) Biomechanical investigations of different meniscal repair implants in comparison with horizontal sutures on human meniscus. Arthroscopy 17:439–444
Bessette GC (1992) The meniscus. Orthopedics 15:35–42
Busenkell GL, Lee CS (1992) Arthroscopic meniscal repair: a posterior cannulated technique. Arthroscopy 8:247–253
Buseck MS, Noyes FR (1991) Arthroscopic evaluation of meniscal repairs after anterior cruciate ligament reconstruction and immediate motion. Am J Sports Med 19:489–494
Cannon WD Jr, Vittori JM (1992) The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 20:176–181
Cassidy RE, Shaffer AJ (1981) Repair of peripheral meniscus tears. A preliminary report. Am J Sports Med 9:209–214
Cetinkaya SM, Boynuk B, Taser O (1997) The comparison of the failure strength of meniscus arrows (absorbable fixation material) with different meniscal suturing techniques. Acta Orthop Traumatol Turc 31:453–455
Clark CR, Ogden JA (1983) Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am 65:538–547
Coen MJ, Caborn DN, Urban W, Nyland J, Johnson DL (1999) An anatomic evaluation of T-Fix suture device placement for arthroscopic all-inside meniscal repair. Arthroscopy 15:275–280
DeHaven KE, Black KP, Griffiths HJ (1989) Open meniscus repair. Technique and two to nine year results. Am J Sports Med 17:788–795
DeHaven KE, Lohrer WA, Lovelock JE (1995) Long-term results of open meniscal repair. Am J Sports Med 23:524–530
Doral MN Leblebicioglu G, Atay A (1999) Treatment of meniscal injuries in the anterior cruciate ligament injured knees. Acta Orthop Traumatol Turc 33:426–429
Fairbank TJ (1948) Knee joint changes after menisectomy. J Bone Joint Surg Br 30:664–670
Henning CE (1983) Arthroscopic repair of meniscus tears. Orthopedics 6:1130–1132
Henning CE, Clark JR, Lynch MA, Stallbaumer R, Yearout KM, Vequist SW (1988) Arthroscopic meniscus repair with a posterior incision. Instr Course Lect 37:209–223
Henning CE, Lynch MA, Yearout KM, Vequist SW, Stallbaumer RJ, Decker KA (1990) Arthroscopic meniscal repair using an exogenous fibrin clot. Clin Orthop 252:64–72
Jakob RP, Staubli HU, Zuber K, Esser M (1988) The arthroscopic meniscal repair. Techniques and clinical experience. Am J Sports Med 16:137–142
Mariani PP, Santori N, Adriani E, Mastantuono M (1996) Accelerated rehabilitation after arthroscopic meniscal repair: a clinical and magnetic resonance imaging evaluation. Arthroscopy 12:680–686
Morgan CD (1991) The ‘all-inside’ meniscus repair. Arthroscopy 7:120–125
Morgan CD, Casscells SW (1986) Arthroscopic meniscus repair: a safe approach to the posterior horns. Arthroscopy 2:3–12
Morgan CD, Wojtys EM, Casscells CD, Casscells SW (1991) Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med 19:632–637
Murray R, Bohannon R, Tiberio D, Dewberry M, Zannotti C (2002) Pelvifemoral rhythm during unilateral hip flexion in standing. Clin Biomech 17:147–151
Noyes FR, Mangine RE, Barber S (1987) Early knee motion after open and arthroscopic anterior cruciate ligament reconstruction. Am J Sports Med 15:149–160
Noyes FR, Barber-Westin SD (2000) Arthroscopic repair of meniscus tears extending into the avascular zone with or without anterior cruciate ligament reconstruction in patients 40 years of age and older. Arthroscopy 16:822–829
Rosenberg TD, Scott SM, Coward DB, Dunbar WH, Ewing JW, Johnson CL, Paulos LE (1986) Arthroscopic meniscal repair evaluated with repeat arthroscopy. Arthroscopy 2:14–20
Ryu RK, Dunbar WH (1988) Arthroscopic meniscal repair with two-year follow-up: a clinical review. Arthroscopy 4:168–173
Shelbourne KD, Patel DV, Adsit WS, Porter DA (1996) Rehabilitation after meniscal repair. Clin Sports Med 15:595–612
Stone RG, Frewin PR, Gonzales S (1990) Long-term assessment of arthroscopic meniscus repair: a two- to six-year follow-up study. Arthroscopy 6:73–78
Stone RG, Miller GA (1985) A technique of arthroscopic suture of torn menisci. Arthroscopy 1:226–232
Stone RG, VanWinkle GN (1986) Arthroscopic review of meniscal repair: assessment of healing parameters. Arthroscopy 2:77–81
Tenuta JJ, Arciero RA (1994) Arthroscopic evaluation of meniscal repairs. Factors that effect healing. Am J Sports Med 22:797–802
Tiberio D (1994) Functional rehab in ankle injuries. Rehab Management: Interdisciplinary J Rehab 7:31–33, 131–132
Wacker F, Konig H, Felsenberg D, Wolf KJ (1994) MRT of the knee joint of juvenile footballers – are there early changes in the knee due to competitive sport? Fortschritte Geb Rontgenstr Neuen Bildgebenden Verfahren 160:149–153
Walker PS, Erkman MJ (1975) The role of the menisci in force transmission across the knee. Clin Orthop 109:184–192
Warren RF (1985) Arthroscopic meniscus repair. Arthroscopy 1:170–172
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kocabey, Y., Nyland, J., Isbell, W.M. et al. Patient outcomes following T-Fix meniscal repair and a modifiable, progressive rehabilitation program, a retrospective study. Arch Orthop Trauma Surg 124, 592–596 (2004). https://doi.org/10.1007/s00402-004-0649-6
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-004-0649-6