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Better outcomes for arthroscopic repair vs observation for patients with meniscal root tears
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BOSTON — Patients who undergo all-inside arthroscopic repair for posterior meniscal root tears have improved clinical outcomes compared with patients managed nonoperatively, according to results of a study presented here.
“Root repairs could be performed in these older patients using an all-inside technique and achieving reasonable results for medium term in this hard-to-treat population,” Jason L. Dragoo, MD, said at the American Orthopaedic Society for Sports Medicine Annual Meeting.
Dragoo identified 48 patients who were diagnosed with a posterior meniscal root tear between 2006 and 2015. Thirty patients were in the arthroscopic repair group and 18 patients were in the observation group. Patients in the arthroscopic repair group had meniscal root repair where two all-inside sutures were used to reduce the meniscus back to its non-extruded and anatomic position and one vertical mattress suture was then placed in the posterior portion of the meniscus to stabilize the repair in its reduced position against the posterior capsule.
KOOS subscores were the primary outcome measure at a minimum 2-year follow-up, with 4.5 years as the average follow-up. Dragoo compared rates of conversation to total knee arthroplasty.
At 2-year follow-up, patients in the arthroscopic repair group had significantly larger increases in KOOS subscores, Lysholm scores, Tegner scores and VR12 PCS scores compared with patients in the observation group. Patients in the observation group showed a significant difference in mean KOOS pain, KOOS ADL and VR12 PCS scores. Patients in the arthroscopic reconstruction group had a larger increase in mean KOOS pain scores, KOOS symptom scores and Lysholm scores. Additionally, 3.3% of patients in the arthroscopic reconstruction group had a TKA, which was lower than the 33.3% of patients in the nonoperative group. – by Kristine Houck, MA, ELS
Reference:
Dragoo JL. Abstract 2. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 11-14, 2019; Boston.
Disclosure: Dragoo reports he is on the speakers bureau for Ossur; is a consultant for Beckman Dickenson, Zimmer Biomet, Breg, ConMed Linvatec, DePuy, DJ Orthopaedics, Flexion Therapeutics, Genzyme Harvest Technologies, Joint Restoration Foundation, KCRN Research, Maximed, Ossur, Regeneration Technologies Inc., RNL Bio, Sideline Sports Doc LLC; and receives research support from ConMed Linvatec, Ossur, RTI, Zimmer Biomet and other financial/material support from Emcyte, Harvest Technologies and RTI.