Save the meniscus - Clinical outcomes of meniscectomy versus meniscal repair

Abstract

Purpose: This study was designed to compare the clinical outcomes of meniscectomy versus repair and to study the effects of (1) duration of follow-up and (2) concomitant anterior cruciate ligament (ACL) reconstruction on clinical outcomes.

Methods: A retrospective study was conducted, involving 112 knees of 106 patients who underwent meniscus surgery, either partial meniscectomy or meniscal repair between 2008 and 2016. There were 42 meniscectomies and 70 meniscal repairs. Patients were graded pre- and post-operatively using the International Knee Documentation Committee (IKDC) score and Tegner Activity Level Scale through case notes review. Statistical analysis was done using the paired Student's t-test (two-tailed) or Wilcoxon signed-rank test for paired scores. The two-sample Student's t-test (two-tailed) or Mann-Whitney U test was used for independent scores. Multiple variable linear regression analysis was used to assess the importance of the variables on outcomes. A statistical significance is taken as p < 0.05.

Results: Meniscectomy and repair had good outcomes. IKDC scores improved from 46.6 to 81.7 after meniscectomy and from 45.9 to 84.4 after repair ( p < 0.001). Meniscectomy fared worse in late follow-up (>18 months), decreasing from 88.2 in early follow-up (≤18 months) to 72.1 ( p < 0.05). The post-operative scores in meniscal repair were maintained in the late follow-up group (82.9 compared to 87.1, p > 0.05). Concomitant ACL reconstruction improved the outcomes of meniscectomy (IKDC and Tegner: p < 0.05) and repair (IKDC and Tegner: p < 0.05).

Conclusion: Both meniscectomy and meniscal repair are viable surgical techniques for meniscal injury and have good outcomes. Meniscal repair has a better prognosis in the long run.

Keywords: clinical outcomes; meniscectomy; meniscus; repair.