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Outcome of repaired unstable meniscal tears in children and adolescents.

Kraus T, Heidari N, Švehlík M, Schneider F, Sperl M, Linhart W - Acta Orthop (2012)

Bottom Line: Intraoperative documentation followed the IKDC 2000 standard.Outcome measurements were the Tegner score (pre- and postoperatively) and the Lysholm score (postoperatively) after an average follow-up period of 2.3 years, with postoperative arthroscopy and MRT in some cases. 24 of the 29 meniscal lesions healed (defined as giving an asymptomatic patient) regardless of location or type. 4 patients re-ruptured their menisci (all in the pars intermedia) at an average of 15 months after surgery following a new injury.Mean Lysholm score at follow-up was 95, the Tegner score deteriorated, mean preoperative score: 7.8 (4-10); mean postoperative score: 7.2 (4-10).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Orthopaedics, Medical University of Graz, Graz, Austria. tanja.kraus@medunigraz.at

ABSTRACT

Background: Unstable meniscal tears are rare injuries in skeletally immature patients. Loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. This study deals with the outcome of intraarticular meniscal repair and factors that affect healing. Parameters of interest were type and location of the tear and also the influence of simultaneous reconstruction of a ruptured ACL.

Methods: We investigated the outcome of 25 patients (29 menisci) aged 15 (4-17) years who underwent surgery for full thickness meniscal tears, either as isolated lesions or in combination with ACL ruptures. Intraoperative documentation followed the IKDC 2000 standard. Outcome measurements were the Tegner score (pre- and postoperatively) and the Lysholm score (postoperatively) after an average follow-up period of 2.3 years, with postoperative arthroscopy and MRT in some cases.

Results: 24 of the 29 meniscal lesions healed (defined as giving an asymptomatic patient) regardless of location or type. 4 patients re-ruptured their menisci (all in the pars intermedia) at an average of 15 months after surgery following a new injury. Mean Lysholm score at follow-up was 95, the Tegner score deteriorated, mean preoperative score: 7.8 (4-10); mean postoperative score: 7.2 (4-10). Patients with simultaneous ACL reconstruction had a better outcome.

Interpretation: All meniscal tears in the skeletally immature patient are amenable to repair. All recurrent meniscal tears in our patients were located in the pars intermedia; the poorer blood supply in this region may give a higher risk of re-rupture. Simultaneous ACL reconstruction appears to benefit the results of meniscal repair.

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Location of meniscal tears in relation to vascular zones. Most unstable mensical tears in skeletally immature patients were found in the red-red and red-white zone; 5 were found in the white-white zone and 5 were found between these two zones.
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Figure 2: Location of meniscal tears in relation to vascular zones. Most unstable mensical tears in skeletally immature patients were found in the red-red and red-white zone; 5 were found in the white-white zone and 5 were found between these two zones.

Mentions: We identified 25 patients (13 boys) with 29 meniscal injuries that were eligible for inclusion in the study. All operations were performed by a single surgeon (FS). Average age at the time of operation was 15 (4–17) years. The mean postoperative follow-up was 27 (13–60) months. All meniscal tears were traumatic and none were associated with a discoid meniscus (Table and Figures 1 and 2).


Outcome of repaired unstable meniscal tears in children and adolescents.

Kraus T, Heidari N, Švehlík M, Schneider F, Sperl M, Linhart W - Acta Orthop (2012)

Location of meniscal tears in relation to vascular zones. Most unstable mensical tears in skeletally immature patients were found in the red-red and red-white zone; 5 were found in the white-white zone and 5 were found between these two zones.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369152&req=5

Figure 2: Location of meniscal tears in relation to vascular zones. Most unstable mensical tears in skeletally immature patients were found in the red-red and red-white zone; 5 were found in the white-white zone and 5 were found between these two zones.
Mentions: We identified 25 patients (13 boys) with 29 meniscal injuries that were eligible for inclusion in the study. All operations were performed by a single surgeon (FS). Average age at the time of operation was 15 (4–17) years. The mean postoperative follow-up was 27 (13–60) months. All meniscal tears were traumatic and none were associated with a discoid meniscus (Table and Figures 1 and 2).

Bottom Line: Intraoperative documentation followed the IKDC 2000 standard.Outcome measurements were the Tegner score (pre- and postoperatively) and the Lysholm score (postoperatively) after an average follow-up period of 2.3 years, with postoperative arthroscopy and MRT in some cases. 24 of the 29 meniscal lesions healed (defined as giving an asymptomatic patient) regardless of location or type. 4 patients re-ruptured their menisci (all in the pars intermedia) at an average of 15 months after surgery following a new injury.Mean Lysholm score at follow-up was 95, the Tegner score deteriorated, mean preoperative score: 7.8 (4-10); mean postoperative score: 7.2 (4-10).

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Orthopaedics, Medical University of Graz, Graz, Austria. tanja.kraus@medunigraz.at

ABSTRACT

Background: Unstable meniscal tears are rare injuries in skeletally immature patients. Loss of a meniscus increases the risk of subsequent development of degenerative changes in the knee. This study deals with the outcome of intraarticular meniscal repair and factors that affect healing. Parameters of interest were type and location of the tear and also the influence of simultaneous reconstruction of a ruptured ACL.

Methods: We investigated the outcome of 25 patients (29 menisci) aged 15 (4-17) years who underwent surgery for full thickness meniscal tears, either as isolated lesions or in combination with ACL ruptures. Intraoperative documentation followed the IKDC 2000 standard. Outcome measurements were the Tegner score (pre- and postoperatively) and the Lysholm score (postoperatively) after an average follow-up period of 2.3 years, with postoperative arthroscopy and MRT in some cases.

Results: 24 of the 29 meniscal lesions healed (defined as giving an asymptomatic patient) regardless of location or type. 4 patients re-ruptured their menisci (all in the pars intermedia) at an average of 15 months after surgery following a new injury. Mean Lysholm score at follow-up was 95, the Tegner score deteriorated, mean preoperative score: 7.8 (4-10); mean postoperative score: 7.2 (4-10). Patients with simultaneous ACL reconstruction had a better outcome.

Interpretation: All meniscal tears in the skeletally immature patient are amenable to repair. All recurrent meniscal tears in our patients were located in the pars intermedia; the poorer blood supply in this region may give a higher risk of re-rupture. Simultaneous ACL reconstruction appears to benefit the results of meniscal repair.

Show MeSH
Related in: MedlinePlus