Purpose: The all-inside technique using the Meniscus Arrow (Bionx Implants, Malvern, PA) has
become a popular method for repairing meniscal tears. The few published clinical studies
have been promising. The present study, with longer follow-up and larger numbers,
does not show encouraging results. The clinical efficacy, failure rate, and associated
complications of meniscal repair using the Meniscus Arrow with a minimum follow-up
of 3 years are described. Type of Study: Consecutive case series. Methods: We studied 60 consecutive meniscal repairs in 57 patients (average age, 27 years)
using exclusively the Meniscus Arrow. Follow-up averaged 54 months (range, 36 to 70
months). The anterior cruciate ligament (ACL) was intact in 12 knees (12 repairs),
whereas 42 patients (45 repairs) underwent concomitant ACL reconstruction. One patient
(2 repairs) had radiofrequency shrinkage of the ACL and another patient (1 repair)
underwent concomitant arthroscopic fixation of a tibial eminence fracture. Results: Seventeen of 60 repairs (28%) were documented as failures by repeat arthroscopy or
magnetic resonance imaging; 5 of 12 repairs (42%) performed in knees with an intact
ACL failed; and 9 of 45 menisci (20%) repaired in conjunction with an ACL reconstruction
also failed. The remaining 3 failures occurred in knees with unsuccessful ACL procedures.
The type of meniscus tear and the postoperative rehabilitation regimen were also factors
that influenced the success rate in this study. Fifteen patients (26%) underwent a
second operation because of persistent postoperative symptoms. One patient, whose
repair failed, deferred a repeat operation after sustaining a postoperative pulmonary
embolism. Conclusions: Contrary to previously published studies that reported good clinical results, this
series revealed a 28% failure rate with significant postoperative complications, such
as chondral scoring, fixator breakage, and postoperative joint-line irritation. This
study has raised concerns about the continued liberal use of the Bionx Meniscus Arrow,
leading the authors to abandon its use for repairing meniscal tears. Level of Evidence: Level IV.
Key Words
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© 2005 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
