Pediatric patients had 11% complication rate 8 months after arthroscopic meniscus repair
Key takeaways:
- Pediatric patients with an isolated meniscus repair had a complication rate of 14.25%.
- Researchers found no statistical cause for the failed meniscal repairs.
NEW ORLEANS — Pediatric patients who underwent arthroscopic meniscus repair had a complication rate around 11% at 8-month follow-up, with the highest complication rate found among those with isolated meniscus repairs.
In a prospective, multicenter, quality improvement, registry study, Henry B. Ellis Jr., MD, and colleagues used the Clavien-Dindo classification system to identify complications among more than 2,000 arthroscopic meniscus repairs in pediatric patients. Ellis noted patients with type I classification were excluded due to too much variability and there were no patients reported that had type IV or type V classification.
“Type II [classification] is any deviation from a normal postoperative course. So, if you have stiffness and more physical therapy or more clinic visits, that would be considered a type II. If [you need] an intervention, like surgery, it then becomes a type III,” Ellis said in his presentation at the Arthroscopy Association of North America Annual Meeting.
Ellis noted about one-fourth of patients had an isolated meniscus repair and most patients had a meniscus repair combined with an ACL repair. The overall complication rate was 11%, according to Ellis. He noted patients with isolated meniscus repairs had a complication rate of 14.25%, of which 5.5% were failed repairs at 8 months postoperatively.
“We couldn’t find any factors, implant, location – nothing statistically came out as a specific area that caused these failed repairs,” Ellis said.
Among more recent data of 3,777 arthroscopic meniscus repairs, Ellis noted an overall failed repair rate of 1.2%, with around 6% of failed repairs found among isolated meniscus repairs.
“Now, we just need to know what our long-term failure rate is going to look like.” Ellis said. “The data at 2 years is probably going to be more important than 8 months.”
Perspective
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The increase in youth sports and sports specialization has led to an increase in meniscal injuries in the pediatric population. Understanding the types of meniscal tears, location of tears, repair techniques and, most importantly, what leads to failure will be valuable information when treating meniscal injuries in these young athletes.
Henry B. Ellis Jr., MD, and colleagues initially enrolled more than 2,000 pediatric patients with meniscal tears in a multicenter, prospective, quality improvement registry to study the characteristics and incidences of complications of meniscus repair in this population. They found a higher complication rate in isolated tears and no association with repair technique and complications. These findings are much aligned with the current adult literature on meniscal tears.
Interestingly, as the study progressed, the incidence of complications decreased. One might wonder: Are we getting better at repairing the meniscus, especially as repair techniques continue to improve? I applaud Ellis and his team for undertaking this multicentered study to understand and, in turn, improve the quality of care for these young patients and I look forward to seeing their future data.
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Ellis HB Jr., et al. Pediatric meniscus repair: Safety profile based on greater than 2,000 arthroscopic meniscus repairs. Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
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