ARTHROSCOPIC REPAIR OF MENISCAL TEARS THAT EXTEND INTO THE AVASCULAR ZONE - A REVIEW OF 198 SINGLE AND COMPLEX TEARS

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.