Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticlesArthroscopic repair of meniscus tears extending into the avascular zone with or without anterior cruciate ligament reconstruction in patients 40 years of age and older*,**
Section snippets
Subjects
Between May 1991 and October 1996, 31 consecutive meniscal tears in 30 patients 40 years of age and older that extended into the central one-third zone of the meniscus, or had a rim width of 4 mm or greater, were repaired by one of us (F.R.N.). To be included in the study, a patient had to have had either a clinical examination at least 2 years postoperatively, an arthroscopic examination after the initial repair, or both.
Thirty meniscal repairs (97%) in 29 patients met the criteria; 1 patient
Evaluation and follow-up arthroscopy
At follow-up, 28 meniscal repairs (93%) were asymptomatic for tibiofemoral joint symptoms. Two knees had tibiofemoral symptoms: 1 had repeat arthroscopy, and the other patient elected not to have further surgery (Table 1).
The indications for follow-up arthroscopy on the 6 meniscal repairs were reinjury without meniscal symptoms in 3; diagnostic, in conjunction with removal of hardware in 2; and continuing meniscal symptoms without reinjury in 1 patient. Three of the meniscal repairs were
Discussion
To our knowledge, this report is the first in the English language literature to critically evaluate arthroscopic meniscal repairs in patients 40 years of age or older with exclusively single or complex tears that extended into the avascular zone. We found that 26 of the 30 meniscal repairs (87%) were asymptomatic for tibiofemoral joint symptoms and did not require removal at follow-up. This rate should not be interpreted as the rate of meniscal healing, but the incidence of tibiofemoral joint
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Supported in part by the Cincinnati Sportsmedicine Research and Education Foundation.
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Address correspondence and reprint requests to Frank R. Noyes, M.D., Cincinnati Sportsmedicine Research and Education Foundation, Deaconess Hospital, 311 Straight St, Cincinnati, OH 45219, U.S.A. E-email: [email protected]