Mh. Rubman et al., ARTHROSCOPIC REPAIR OF MENISCAL TEARS THAT EXTEND INTO THE AVASCULAR ZONE - A REVIEW OF 198 SINGLE AND COMPLEX TEARS, American journal of sports medicine, 26(1), 1998, pp. 87-95
We assessed the results of 198 meniscal tears that had a major segment
in the central avascular region repaired with an arthroscopically ass
isted inside-out technique. There were 177 patients whose mean age was
28 years, Eighty-two percent were injured during sports, and 71% also
required anterior cruciate ligament reconstruction, The menisci were
evaluated by clinical examination (180 repairs) a mean of 42 months po
stoperatively, by follow-up arthroscopic evaluation (91 repairs) a mea
n of 18 months postoperatively, or both. At followup, 159 (80%) of the
198 tears were asymptomatic for tibiofemoral joint symptoms, and 39 (
20%) required repeat arthroscopic surgery for these symptoms. Of the 9
1 repairs evaluated arthroscopically, 23 (25%) were classified as heal
ed, 35 (38%) as partially healed, and 33 (36%) as failed. We recommend
repair of meniscal tears that extend into the avascular region for se
lect patients, including those in their 20s and 30s and highly competi
tive athletes, This study's reoperation rate of 20% should not be inte
rpreted as the rate of meniscal healing, but as the incidence of tibio
femoral joint symptoms. Even though this is a higher rate than that re
ported for the repair of peripheral meniscal tears, we believe the ben
efits of a potentially functional meniscus outweigh the risks of reope
ration.