Clinical Outcomes After Revision Meniscus Repair

Abstract

Purpose: To (1) report outcomes for patients who underwent revision meniscal repair and (2) define both clinical and surgical risk factors for recurrent failure.

Methods: The records of all patients who underwent revision meniscal repair between 1997 and 2012 were retrospectively reviewed. Surgical technique of primary and revision meniscus repair was detailed, and tears were characterized by type and location. Clinical examination and International Knee Documentation Committee (IKDC) and Tegner scores were used to determine outcomes after revision meniscus repair. Radiographs were reviewed and graded for degenerative changes. Risk factors for failure were analyzed.

Results: Thirty-four patients (24 male/10 female) with an average age of 22 ± 6 years (range, 14 to 38) were included in this study. Twelve lateral menisci and 22 medial meniscal repairs were revised at mean 25 ± 20 months (range, 2 to 76) after primary repair for 11 simple, 9 bucket-handle, and 14 complex tear patterns. Twenty-one tears occurred in the red-red zone and 13 in the red-white zone. At 72 ± 56-month follow-up (range, 2 to 17 years), 7 (21%) cases had documented failure of revision repairs and underwent subsequent partial meniscectomy. Mean Tegner score for all patients was 6.2 ± 1.5 (range, 3 to 9) and IKDC score was 84.8 ± 13.1 (range, 51.7 to 100) at final follow-up. Affected side joint space on radiographs remained stable from a baseline of 4.26 ± 0.88 mm to a final of 4.01 ± 0.84 mm. Multivariable regression identified younger patient age as an independent risk factor for failed revision meniscal repair (P = .01).

Conclusions: In this study of select revision meniscus repairs, 79% of patients were pain free, without any mechanical symptoms or additional surgeries at a mean of 6 years after revision repair. Younger patients may be at higher risk of failure of the revision meniscus repair.

Level of evidence: Level IV, therapeutic case series.