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. 2012 Jun;83(3):261-6.
doi: 10.3109/17453674.2012.693017. Epub 2012 May 23.

Outcome of repaired unstable meniscal tears in children and adolescents

Tanja Kraus  1 , Nima Heidari, Martin Švehlík, Frank Schneider, Matthias Sperl, Wolfgang Linhart
Affiliations

Outcome of repaired unstable meniscal tears in children and adolescents

Tanja Kraus et al. Acta Orthop. 2012 Jun.

Abstract

Background: Unstable meniscal tears are rare injuries in skeletally immature patients. Loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. This study deals with the outcome of intraarticular meniscal repair and factors that affect healing. Parameters of interest were type and location of the tear and also the influence of simultaneous reconstruction of a ruptured ACL.

Methods: We investigated the outcome of 25 patients (29 menisci) aged 15 (4-17) years who underwent surgery for full thickness meniscal tears, either as isolated lesions or in combination with ACL ruptures. Intraoperative documentation followed the IKDC 2000 standard. Outcome measurements were the Tegner score (pre- and postoperatively) and the Lysholm score (postoperatively) after an average follow-up period of 2.3 years, with postoperative arthroscopy and MRT in some cases.

Results: 24 of the 29 meniscal lesions healed (defined as giving an asymptomatic patient) regardless of location or type. 4 patients re-ruptured their menisci (all in the pars intermedia) at an average of 15 months after surgery following a new injury. Mean Lysholm score at follow-up was 95, the Tegner score deteriorated, mean preoperative score: 7.8 (4-10); mean postoperative score: 7.2 (4-10). Patients with simultaneous ACL reconstruction had a better outcome.

Interpretation: All meniscal tears in the skeletally immature patient are amenable to repair. All recurrent meniscal tears in our patients were located in the pars intermedia; the poorer blood supply in this region may give a higher risk of re-rupture. Simultaneous ACL reconstruction appears to benefit the results of meniscal repair.

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Figures

Figure 1.
Figure 1.
The number of meniscal lesions in each part of the meniscus. Note that most lesions in this age group occur in the pars intermedia and the posterior horn. PH: posterior horn; PI: pars intermedia; AH: anterior horn.
Figure 2.
Figure 2.
Location of meniscal tears in relation to vascular zones. Most unstable mensical tears in skeletally immature patients were found in the red-red and red-white zone; 5 were found in the white-white zone and 5 were found between these two zones.
See this image and copyright information in PMC

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