Arthroscopic Meniscal Repair: University Hospital Southampton Experience

Abstract

Introduction The meniscus plays an integral role in the proper functioning of the knee joint. Located between the articular surfaces of the tibia and femur, the meniscus functions to provide stability to the knee joint, even out axial load, absorb shock, and provide some lubrication to the knee joint. Accordingly, treatment of meniscal injuries aims to preserve as much meniscal tissue as possible to avoid the myriad complications that arise from its removal. This study of the all-inside technique for meniscal repair evaluates the University Hospital Southampton experience by comparing our outcomes with the available literature. Patients and methods This is a retrospective study from January 2016 to December 2020. Records of patients were obtained through the preoperative assessment clinics network and electronic notes. The endpoints of the study were defined as patients who either were discharged, experienced failure of repair, i.e., symptomatic or magnetic resonance imaging (MRI) changes, or were offered re-surgery. Results Eighty-one patients, comprising 51 males and 30 females, were included in the study, and 85 repairs were performed. A steady increase in the number of procedures was observed year on year until the outbreak of COVID-19. The mean age of patients was 24.7 years, with a range of 39 years. The medial meniscus was found to be injured more often than the lateral meniscus. The most commonly observed injury pattern was the bucket handle (BH) type. Anterior cruciate ligament (ACL) injury was found to be associated with meniscal injuries in around half of patients. The reason for this occurrence can be attributed to the ligamentous connection between the medial meniscus and the anterior cruciate ligament in the phenomenon described in the "unhappy triad." On average, three FasT-Fix sutures were required per procedure. Discussion and conclusion After a follow-up of 11 months, 11 (13.6%) treated patients were noted to have failed repair, as defined by the endpoint criteria. Age and acuity were noted to not affect outcomes, and the results suggest that males are at higher risk of failed repair than females (p<0.05).