Purpose: With most all-inside arthroscopic meniscal repair devices, the surgeon has no need for additional incisions or arthroscopic knot tying, and surgical time is decreased compared with traditional suture repair. Although previous studies have examined the pullout strength of various all-inside devices, clinical data is lacking and has been presented for only a few implants. This study evaluates the clinical results of meniscal repair using a bioabsorbable screw.
Type of study: Retrospective case series.
Methods: Twenty-five patients underwent 26 all-inside meniscal repairs using this device. Patient interviews were performed as was retrospective evaluation of patient records. Complications and repeat surgeries were noted.
Results: The average age of the patients was 28.8 years (range, 15 to 44). The surgeries included 19 medial meniscus repairs and 7 lateral meniscus repairs; 12 patients underwent concomitant anterior cruciate ligament (ACL) reconstruction. We found 11 isolated meniscal repairs in stable knees and 2 isolated meniscal repairs in ACL-deficient knees. An average of 3.6 screws (range, 1 to 6) were used during the meniscal repairs. Eighteen of 25 patients were contacted at an average of 106 weeks (range, 70 to 189) postoperatively. The mean Tegner score was 5, and the mean modified Lysholm score was 84. Three repeat surgeries were performed for failure of meniscal healing, and one repeat surgery was performed for migration of an implant. An additional patient who underwent medial meniscal repair noted a painless mild prominence on the medial aspect of the knee approximately 8 weeks after surgery. This prominence resolved completely over 6 months and did not require a second surgery.
Conclusions: The bioabsorbable screw appears to be a safe and effective device for meniscal repair. Rare complications occurred that involved implant migration and transient inflammatory responses. Clinical success appears comparable to reported results with other methods of meniscal repair.
Level of evidence: Level IV, case series.