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Minerva Ortopedica e Traumatologica 2017 September;68(3):144-9

DOI: 10.23736/S0394-3410.17.03829-2


lingua: Inglese

Clinical and functional results of meniscal suture alone or associated with anterior cruciate ligament repair

Alessandro BISTOLFI 1 , Luca DROCCO 1, Fabrizio GALETTO 1, Eugenio GRAZIANO 1, Enzo C. CENNA 1, Laura RAVERA 2, Alessandro MASSÈ 1, 2

1 Department of Orthopedics, Traumatology and Rehabilitation, Orthopedic and Trauma Center, CTO, Hospital Città della Salute e della Scienza, Turin, Italy; 2 School of Orthopedics and Traumatology, University of Turin, Turin, Italy


BACKGROUND: The biological and mechanical importance of the meniscus is recognized; nevertheless, since the risks of failure of meniscal sutures may be high, concerns about the opportunity of meniscal repair procedures still exist. The purposes of this study were: 1) to determine the clinical results of meniscal repair alone or associated with anterior cruciate ligament (ACL) reconstruction, hypothesizing that meniscal suture is safe and allows recover of function and sport activity; 2) to identify negative prognostic factors; 3) to compare different suture techniques; 4) to guide future clinical and surgical decisions.
METHODS: One-hundred-eleven meniscal sutures associated with 109 ACL reconstructions in 109 patients (group-1) and 44 isolated meniscal repairs in 44 patients (group-2) have been studied. The meniscal sutures have been performed arthroscopically with different techniques: 118 outside-in, 42 all-inside and 5 mixed sutures. Evaluation was based on the success rate of the meniscal suture (failure=meniscectomy), functional and clinical evaluation scores, patient satisfaction and return to sport rate.
RESULTS: The mean follow-up was 22.8 and 29.8 months for group-1 and group-2. The overall clinical success rate in group-1 was 98% compared to 91% of group-2. Simple tears gave better results compared to complex tears. Sutures in group-1 performed better than in group-2. Eighty patients of group-1 (73%) and 26 patients (59%) of group-2 returned to sport at the same level. The mean values of the IKDC, modified Lysholm and KOOS scores improved from preoperative to postoperative. The clinical success of meniscal repair is higher in association with ACL reconstruction than alone; prognostic factors that may affect the results are the complexity of the lesion and knee instability. The results did not allow preferring one of the two evaluated surgical techniques.
CONCLUSIONS: Meniscal suture provide good results and must be pursued in all cases with favorable anatomical features.

KEY WORDS: Meniscus - Suture techniques - Anterior cruciate ligament reconstruction

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