Arthroscopic Suture Anchor Repair Versus Pullout Suture Repair in Posterior Root Tear of the Medial Meniscus: A Prospective Comparison Study

Kim, Jae-Hwa; Chung, Ju-Hwan; Lee, Dong-Hoon; Lee, Yoon-Seok; Kim, Jung-Ryul; Ryu, Keun-Jung

doi:10.1016/j.arthro.2011.06.033

« Previous Next »Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 27, Issue 12 , Pages 1644-1653, December 2011

Arthroscopic Suture Anchor Repair Versus Pullout Suture Repair in Posterior Root Tear of the Medial Meniscus: A Prospective Comparison Study

Jae-Hwa Kim, M.D., Ph.D.
- Center for Joint Disease, Department of Orthopaedic Surgery, School of Medicine, CHA Bundang Medical Center, Sung-Nam Si, South Korea
- Address correspondence to Jae-Hwa Kim, M.D., Ph.D., Center for Joint Disease, Department of Orthopaedic Surgery, School of Medicine, CHA Bundang Medical Center, 351 Sung-Nam, Kyungkido, South Korea
Ju-Hwan Chung, M.D.
- Center for Joint Disease, Department of Orthopaedic Surgery, Seoul Nanoori Hospital, Seoul, South Korea
Dong-Hoon Lee, M.D.
- Center for Joint Disease, Department of Orthopaedic Surgery, School of Medicine, CHA Bundang Medical Center, Sung-Nam Si, South Korea
Yoon-Seok Lee, M.D.
- Center for Joint Disease, Department of Orthopaedic Surgery, School of Medicine, CHA Bundang Medical Center, Sung-Nam Si, South Korea
Jung-Ryul Kim, M.D.
- Center for Joint Disease, Department of Orthopaedic Surgery, School of Medicine, CHA Bundang Medical Center, Sung-Nam Si, South Korea
Keun-Jung Ryu, M.D.
- Center for Joint Disease, Department of Orthopaedic Surgery, School of Medicine, CHA Bundang Medical Center, Sung-Nam Si, South Korea

Received 4 August 2010; accepted 24 June 2011. published online 10 October 2011.

Purpose

To evaluate functional and radiographic results of arthroscopic suture anchor repair for posterior root tear of the medial meniscus (PRTMM) and compare with pullout suture repair.

Methods

From December 2006 to August 2008, 51 consecutive patients underwent arthroscopic repair of PRTMM at our hospital. The repair technique was switched over time from pullout suture repair (group 1) to suture anchor repair (group 2). Of the patients, 6 were lost to follow-up, leaving a study population of 45 patients, with 22 menisci (48.9%) in group 1 and 23 (51.1%) menisci in group 2. The mean follow-up duration was 25.9 months (range, 24 to 27 months) in group 1 and 26.8 months (range, 24 to 28 months) in group 2. Compared variables included International Knee Documentation Committee criteria, Kellgren-Lawrence grade, gap distance at PRTMM, structural healing, meniscal extrusion, and cartilage degeneration of the medial femoral condyle.

Results

At 2 years postoperatively, both groups showed significant improvements in function (P < .05) and did not show significant differences in Kellgren-Lawrence grade (P > .05) compared with preoperatively. On magnetic resonance imaging, the gap distance at PRTMM was 3.2 ± 1.1 mm in group 1 and 2.9 ± 0.9 mm in group 2 preoperatively (P > .05). Complete structural healing was seen in 11 cases in group 1 and 12 cases in group 2 (P > .05). Mean meniscal extrusion of 4.3 ± 0.9 mm (group 1) and 4.1 ± 1.0 mm (group 2) preoperatively was significantly decreased to 2.1 ± 1.0 mm (group 1) and 2.2 ± 0.8 mm (group 2) postoperatively (P < .05). Regardless of repair technique, incompletely healed cases showed progression of cartilage degeneration (4 cases in group 1 and 2 cases in group 2).

Conclusions

For PRTMM, our results show significant functional improvement in both the suture anchor repair and pullout suture repair groups. Reduction of meniscal extrusion seems to be appropriate to preserve its protective role against progression of cartilage degeneration after complete healing at PRTMM.