Purpose: To report the outcomes (subjective function, return to play, complications and reoperations) of arthroscopic all-inside meniscal fixation in a large sample of soccer players with hypermobile lateral meniscus.
Methods: Between 2010 and 2015, 55 patients undergoing surgical treatment for hypermobile lateral meniscus at Mutualidad Catalana de Futbolistas (Barcelona, Spain) were identified. Patients with open physes, associated injuries, discoid meniscus, or clinical follow-up less than 6 months were excluded. Once identified, all patients were contacted over the phone to collect cross-sectional data on International Knee Documentation Committee (IKDC) score, postoperative Tegner score, and postoperative visual analogue scale (VAS) for pain. In addition, complications and reoperations were retrospectively collected.
Results: Forty-six cases (in 45 patients) with a mean (SD) age of 26.3 (9.5) years and mean (SD; range) follow-up of 43 (19.5; 8-73) months were included. The pre- and post-operative median (range) Tegner score was 9 (6-9) and 8 (0-9), respectively. Compared to the preoperative period, the postoperative Tegner score was equal in 27/46 (59%) cases and lower in 16/46 (35%) cases (3 missing values). Return to play was possible in 38/46 (82%) cases, from which 27/46 (59%) corresponded to the same pre-injury activity level. Postoperatively, the median (range) VAS for pain was 1 (0-9), and the mean (SD) subjective IKDC was 86.2 (16.7). Three of the 46 cases (6.5%) required a reoperation because of pain in one patient (meniscal suture failure) and meniscal tear in two patients.
Conclusions: All-inside meniscal fixation is a successful treatment for hypermobile lateral meniscus, which allows acceptable return to play and good function in soccer players at a low reoperation rate. However, according to the present cross-sectional case series, players should be advised that return to the same pre-injury activity level is achieved in only 27 of 46 (59%) of the cases. Surgeons facing with the difficult problem of hypermobile lateral meniscus in soccer players should consider meniscus fixation as an easy and successful option.
Level of evidence: Level IV-Therapeutic Case Series.
Keywords: Hypermobile; Lateral meniscus; Soccer; Treatment.