Repair of Radial Tears of the Lateral Meniscus on a Stable Knee: Results at a Minimum Follow-Up of 2 Years.

INTRODUCTION: In younger patients, meniscal repair is recommended for isolated lateral meniscus tears that are most often due to acute trauma. But there is little published data on the outcomes of repairing this specific type of lesion. The goal of this study was to evaluate the clinical outcomes, report the failure rate of repairing radial tears of the lateral meniscus in stable knees and determine the risk factors for failure.

MATERIALS AND METHODS: All patients who had a stable knee and underwent arthroscopic repair of a radial lateral meniscus tear between April 2013 and December 2019 were reviewed retrospectively. Failure was defined as revision surgery for recurrence of symptoms (pain, locking) with intraoperative confirmation that the meniscus did not heal. The following data were collected: demographics (age, sex, BMI), time to surgery, clinical outcome scores (Tegner, Lysholm, IKDC), surgical details (repair technique, lesion zone, number of sutures).

RESULTS: Thirty patients were included having a mean age of 20.1 years (14-31). The follow-up ranged from 24 to 110 months (mean 66.8 ± 25.2). An all-inside repair was done in 6 patients (20%); an outside-in technique was done in 17 patients (57%) and a combination of all-inside and outside-in was done in 7 patients (23%). Four patients (13%) had a recurrence of their symptoms later on, while participating in sports. All the recurrences were at the initial tear site. The time to revision surgery was 16, 19, 24 and 37 months in these four patients (mean 24 ± 9). All the other patients were able to resume sports at their pre-injury level. Significant improvement in the IKDC, Lysholm and Tegner functional scores were found between the preoperative and postoperative assessments. No statistically significant risk factors for failure were identified.

DISCUSSION: The functional healing rate after repair of a radial lateral meniscus tear in a stable knee was 86% at a mean follow-up of 5 years, with the surgical technique having no impact on the long-term result. Most of the failures occurred within 2 years of the repair procedure. We recommend repairing these tears as they have considerable healing potential.

LEVEL OF EVIDENCE: IV; retrospective observational cohort study.