A Quarter of Meniscal Repairs Fail After Five Years

The long-term rate of failure after menisci repair is similar for all techniques, with a pooled rate of 23.1%, according to a new review.

Researchers at Washington University School of Medicine (St. Louis, MO, USA) and Vanderbilt University School of Medicine (Nashville, TN, USA) conducted a systematic literature review and meta-analysis of 13 studies to investigate the long-term outcomes of meniscal repair at a minimum of five years. Pooling of data and meta-analysis with a random-effects model were performed to evaluate the results.

The researchers found that the pooled rate of menisci repair failure, defined as either reoperation or clinical failure, was 23.1%, and varied from 20.2%–24.3%, based on the status of the anterior cruciate ligament (ACL), the meniscus repaired, and the technique utilized. Failure rates were similar for the medial (24.2%) and lateral (20.2%) meniscus, and for those with an intact or reconstructed ACL. The review was published in the December 19, 2012, issue of the Journal of Bone & Joint Surgery.

“A systematic review of the outcomes of meniscal repair at greater than five years postoperatively demonstrated very similar rates of meniscal failure for all techniques investigated,” concluded lead author Jeffrey Nepple, MD, and colleagues. “The outcomes of meniscal repair at greater than five years postoperatively have not yet been reported for modern all-inside repair devices.”

Treatment options of the meniscus include nonsurgical treatment with rest, ice, compression, elevation, and physical therapy; surgical repair; surgical removal of the torn section (partial meniscectomy); and surgical removal of the entire meniscus (total meniscectomy). Successful repair of meniscus tears depends to a large degree on where the tear is located. While tears at the outer edge of the meniscus tend to heal well, surgical repair of tears that extend into the center of the meniscus are questionable, due to reduced blood supply.

Related Links:
Washington University School of Medicine
Vanderbilt University School of Medicine