Article

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.

Langue : ANGLAIS