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Arthroscopy. 2008 Dec;24(12):1358-66. doi: 10.1016/j.arthro.2008.07.017. Epub 2008 Sep 13.

Second-look arthroscopic evaluation of bucket-handle meniscus tear repairs with anterior cruciate ligament reconstruction: 67 consecutive cases.

Author information

  • 1Sports Medicine Service, Beijing Jishuitan Hospital, Beijing, China. yzyfh@public3.bta.net.cn

Abstract

PURPOSE:

To evaluate arthroscopic second-look bucket-handle meniscus tear (BHMT) repairs using different suturing techniques.

METHODS:

Between May 2002 and September 2006, 122 consecutive cases underwent arthroscopic repair surgery, including 40 males and 24 females (63 with concurrent anterior cruciate ligament [ACL] injury and 1 isolated BHMT) having 67 (60 medial and 7 lateral) repairs available for second-look arthroscopy evaluation. Inclusion criteria for reparability included reducible tears involving red-red and red-white zone without obvious additional complex tears and tissue degeneration, and concurrent ACL injury and/or isolated BHMT. Patients were excluded if they had combined ligaments injuries other than ACL. The arthroscopic suturing techniques, classified according to different involvement of meniscus zones, consisted of typical inside-out and all-inside suture repair with suture hook.

RESULTS:

In a series of 64 second-look cases with 67 repairs, which showed healing after an average of 26 months (range, 14 to 66 mos), 55 repairs (82.1%) were completely healed (and clinically asymptomatic) in 53 cases; 5 cases (5 repairs; 7.5%) had joint line tenderness (incompletely healed and clinically asymptomatic); and 7 repairs (6 medial, and 1 lateral; 10.4%) failed, with recurrent locking or catching in 4 cases (and clinically asymptomatic in 2 cases). The overall success rate, including completely healed and incompletely healed cases, was 89.6%. Four failures occurred in failed ACL-reconstructed knees.

CONCLUSIONS:

For large bucket-handle meniscus tears involving red-red and red-white zones, an arthroscopic hybrid suture technique with ACL reconstruction achieves high anatomic healing results, with an overall meniscal healing rate of 89.6%, including 82.1% completely healed and 7.5% incompletely healed. The failure rate was 10.4% in the average 26-month follow-up period.

LEVEL OF EVIDENCE:

Level IV, therapeutic case series.

PMID:
19038706
[PubMed - indexed for MEDLINE]
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