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. 2022 Sep 1;10(9):23259671221117491.
doi: 10.1177/23259671221117491. eCollection 2022 Sep.

Benefits of Meniscal Repair in Selected Patients Aged 60 Years and Older

Martin Husen  1 , Nicholas I Kennedy  1 , Sara Till  1 , Anna Reinholz  1 , Michael J Stuart  1 , Aaron J Krych  1 , Daniel B F Saris  1   2
Affiliations

Benefits of Meniscal Repair in Selected Patients Aged 60 Years and Older

Martin Husen et al. Orthop J Sports Med. .

Abstract

Background: Little is known about the benefits and outcomes of meniscal repair in patients older than 60 years.

Purpose: To (1) report the clinical and radiographic outcomes of meniscal repair in patients aged ≥60 years and compare them with matched patients who underwent meniscectomy and (2) identify procedural failures.

Study design: Cohort study; Level of evidence, 2.

Methods: We included 32 knees in 32 patients aged ≥60 years (20 female, 12 male; mean age, 64.5 ± 4.6 years) who underwent meniscal repair surgery at a single medical institution between 2010 and 2020. Patients were matched according to age, sex, body mass index, and meniscal tear type with a comparison cohort who underwent meniscectomy (n = 49 patients [49 knees]; 32 female, 17 male). For all patients, demographic information, clinical history, physical examination findings, treatment details, and radiographic images were reviewed and analyzed. At final follow-up (mean, 42.2 months; range, 13-128 months), patients completed the 2000 International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score. Clinical failure was defined as revision surgery and/or progression to total knee arthroplasty (TKA). A matched-pairs t test was used to analyze differences between the 2 treatment groups, and Kaplan-Meier analysis was used to determine the rates of knee osteoarthritis and progression to TKA.

Results: The majority of patients had a medial meniscal tear (72.8%), whereas the lateral meniscus was torn in 27.2% of cases. Most tears were located in the meniscal root (56.8%), followed by the posterior horn (34.6%) and midbody (8.6%). At final follow-up, all outcome scores were higher in the repair group compared with the meniscectomy group (IKDC, 78.9 ± 13.4 vs 56.0 ± 15.4; KOOS, 86.6 ± 11.9 vs 61.7 ± 16.2; Lysholm, 88.3 ± 13.3 vs 68.7 ± 15.2, respectively; P < .001 for all). Clinical failure was observed in 22% of patients in the repair group.

Conclusion: All clinical outcome scores were higher in the meniscal repair group compared with the matched meniscectomy group at final follow-up. The clinical failure rate of the repair group was 22%. These findings support meniscal repair in selected patients aged ≥60 years.

Keywords: meniscal repair; meniscal tear; meniscectomy; older patients; root tear.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: The authors acknowledge support from the Foderaro-Quattrone Musculoskeletal-Orthopaedic Surgery Research Innovation Fund. This study was partially funded by the Deutsche Forschungsgemeinschaft (grant No. 466023693 to M.H.) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases for the Musculoskeletal Research Training Program (T32AR56950). N.I.K. has received hospitality payments from Encore Medical. M.J.S. has received research support from Stryker and consulting fees, nonconsulting fees, and royalties from Arthrex. A.J.K. has received grant support from DJO; consulting fees from Arthrex, the Joint Restoration Foundation, and Responsive Arthroscopy; speaking fees from Arthrex; royalties from Arthrex and Responsive Arthroscopy; and honoraria from Vericel and the Joint Restoration Foundation; he serves on the medical board of trustees for the Musculoskeletal Transplant Foundation. D.B.F.S. has received consulting fees from Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Flowchart showing patient movement through the study for (A) the repair group and (B) the meniscectomy group. ACL, anterior cruciate ligament; PCL, posterior cruciate ligament.
Figure 2.
Figure 2.
Kaplan-Meier survival analysis from failure of initial operative management resulting in either meniscectomy (repair cohort only) or total knee arthroplasty (repair and meniscectomy cohort).
Figure 3.
Figure 3.
Postoperative patient-reported outcome scores. IKDC, International Knee Documentation Committee; KOOS, Knee injury and Osteoarthritis Outcome Score.
Figure 4.
Figure 4.
Scatter matrix of postoperative Lysholm score and body mass index (BMI).
See this image and copyright information in PMC

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References

    1. Abrams GD, Frank RM, Gupta AK, et al. Trends in meniscus repair and meniscectomy in the United States, 2005-2011. Am J Sports Med. 2013;41(10):2333–2339. - PubMed
    1. Barber-Westin SD, Noyes FR. Clinical healing rates of meniscus repairs of tears in the central-third (red-white) zone. Arthroscopy. 2014;30(1):134–146. - PubMed
    1. Barrett GR, Field MH, Treacy SH, Ruff CG. Clinical results of meniscus repair in patients 40 years and older. Arthroscopy. 1998;14(8):824–829. - PubMed
    1. Bhatia S, LaPrade CM, Ellman MB, LaPrade RF. Meniscal root tears: significance, diagnosis, and treatment. Am J Sports Med. 2014;42(12):3016–3030. - PubMed
    1. Brophy RH, Wojahn RD, Lillegraven O, Lamplot JD. Outcomes of arthroscopic posterior medial meniscus root repair: association with body mass index. J Am Acad Orthop Surg. 2019;27(3):104–111. - PubMed

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