DIFFERENT REGIONAL HEALING RATES WITH THE OUTSIDE-IN TECHNIQUE FOR MENISCAL REPAIR

Fifty-one patients with meniscal repair using the outside-in technique were reassessed with second-look arthroscopic procedures (N = 15), ar thrographic examination (N = 41), magnetic resonance imaging (N = 36), or a combination of these techniques. Forty-one medial and 10 lateral menisci were repaired. The average clinical follow-up was 15 months ( range, 3 to 80), Forty-five of 51 patients had tears that were located in or extended into the posterior horn of the medial or lateral menis cus. Complete healing occurred in 23 menisci (45%), partial healing wa s observed in 16 (15 medial, 1 lateral) (32%), and no healing occurred in 12 (24%). Remarkably, in all 15 patients who had tears extending f rom the posterior to the middle third of the medial meniscus that were partially healed, it was always the posterior third that had not full y healed. This finding is statistically significant. In addition, the middle third of these menisci had not fully healed in five patients. N o healing occurred in the two patients with tears in the posterior thi rd of the medial meniscus. Poor healing with the outside-in technique was observed in patients with tears into the posterior horn of the med ial meniscus. For tears in the middle and anterior portion of the medi al meniscus, as well as all lateral meniscus tears, the outside-in tec hnique is our current method of choice.