MENISCEAL SUTURING OF THE KNEE JOINT

• Published in: Hrvatski športskomedicinski vjesnik Vol. 25; no. 1; pp. 35 - 42
• Main Authors: Starcevic, D, Haspl, M, Trsek, D
• Format: Journal Article
• Language: Croatian; English
• Published: 01-07-2010
• ISSN: 0354-0766

The aim of this article is to present the basics of anatomy and histology of the knee joint, biomechanical principles, surgical treatment options, meniscal repair techniques and results. Menisci are important anatomical structures in the knee joint, which enables normal knee function. Their injuries are most commonly injuries of knee joint. With the development and progress of arthroscopy in the last 30 years a variety of minimally invasive, safe and effective techniques of meniscus repair have been developed. In our hospital during the period from September 2008 until October 2009 we have done 503 knee arthroscopy, of which meniscal repair was performed in 39 patients (7%). We used out-in, in-out, and all-inside meniscal repair techniques. Of the 27 patients that we followed, mean age 25 years, 20 were men and 7 women. Recreational sports are engaged in 14 patients, and 9 active. The injury was sports related in 22 patients. Rupture of the medial meniscus (24 patients) was 8 times more common than lateral meniscus (3 patients). Anterior cruciate ligament rupture was present in 10 patients (37%). Patients are followed on average 13 (7-18) months. Of 22 patients who were engaged in sport preoperatively, 17 patients (81%) returned to complete the same level of activity in sport. We have had the occurrence of subcutaneous seroma at the site of the sutures of the meniscus in two patients. One patient underwent subsequent meniscectomy because of the rerupture. In the literature, the authors show the success of meniscal repair in 73% to 95% of cases. The most suitable patients for meniscal repair are those who are younger than 50 years, with fresh, longitudinal, vertical rupture in vascular (red) zone of the meniscus. Menisci show an even greater tendency to healing if repair is done with the reconstruction of the anterior cruciate ligament. Meniscal repair is a procedure that allows healing in some ruptured meniscus and thus prevents the occurrence of early osteoarthritis. Although it requires experience of surgeon, special instruments and prolonged rehabilitation in relation to meniscectomy, meniscal repair show very good results.