Evaluation of early clinical and functional results after suturing of meniscal ruptures under arthroscopic control with “аll-inside” and “inside-out” techniques

Abstract

Modern people with an active lifestyle and increasing of its duration perform more and more physical activity in everyday life and in sports, which increases the risk of meniscus damage. Meniscus surgery, including partial meniscectomy, has become one of the most common surgical orthopedic procedures, and the overall risk of meniscus damage requiring surgery in patients aged 10 to 64 years reaches 15 %. It is known that suturing of the damaged meniscus under arthroscopic control prevents early degenerative changes in the knee joint, especially in younger patients. The aim of the study – to evaluate the early clinical and functional results after suturing of meniscal ruptures under arthroscopic control using the "all-inside" and "inside-out" techniques. Materials and Methods. The study involved 39 patients aged 14 to 39 years with a knee joint injury. During the observation, 5 patients were lost for unknown reasons. Among 34 people included in the follow-up observation, 61.76 % were men (21) and 38.24 % were women (13). The age of patients was (22.3±3.2) years. The mean time from injury to surgery was (26.6±3.8) days. Examination of patients was performed according to the standards of medical care of patients with knee injuries. They included general clinical and instrumental research methods: radio­graphy, sonography and MRI. The system FAST-FIX ™ 360 was used for “all-inside” technique of meniscal rupture suturing and the system Arthrex 2.0 FiberWire Meniscus Repair Needles was used for “inside-out” technique. Results and Discussion. According to the Lysholm J (1982) rating scale, the following results were obtained: “excellent” in 19 (55.89%) patients, “good” – 8 (23.52 %), “satisfactory” 5 (14.70 %) and “not satisfactory "in 2 (5.89 %) patients. The reason of the unsatisfactory results was the early and inadequate load on the joint during rehabilitation in the first 3 months after the surgery. Conclusions. The use of meniscus suture with “all-inside” technique using the system Fast-fix Fast-fix ™ 360 and with “inside-out” technique using the system Arthrex 2.0 FiberWire Meniscus Repair Needles allows safely suturing the ruptures of the meniscus, especially the ruptures of the posterior horn and body and gives good clinical and functional results

Keywords

• trauma
• knee joint
• meniscus damage
• arthroscopy
• meniscus suture