The effect of meniscal repair on preventing early development of osteoarthritis in the knee

This retrospective study presents the long-term results after meniscal repa ir with emphasis on early-development of osteoarthritis in the knee. From 1 984 to 1996 meniscal repair using the inside-out technique was performed on 54 patients. 25 patients had an isolated tear of the meniscus and 29 addit ionally a tear of the anterior cruciate ligament (ACL, combined injury). 18 patients of those with a combined injury showed a stable knee during clini cal follow-up. A separate evaluation of this group was carried out. The mea n follow-up was 6.4 years. 22 patients were examined over a period of 25 ye ars (mean 3.5) after surgery, 32 patients after 5 years (mean 8.9). The cli nical evaluation was carried out using IKDC, Tegner activity scale, Lysholm , and Tapper and Hoover-Score as well as the Fairbank radiographic evaluati on. According to the Fairbank's evaluation the results show that up to 5 ye ars after meniscal repair only minimal radiographic changes were detectable . In only 21 % of patients with an isolated meniscal lesion and in 13 % of those with a stable knee after a combined injury beginning of osteorathriti c changes were noted more than 5 years postoperatively. Early osteoarthriti c changes were present within 5 years after surgery in non-stable knees (un treated rupture, suturing). Patients with meniscal repair mostly regain the ir original Tegner activity level and good to very good results in the clin ical scores. However, the results clearly indicate that the success of meni scal repair depends on the stability of the knee. Thus, meniscal repair in stable knees is recommended to prevent early development of osteoarthritis.