Knee meniscus suturing techniques in children and indications for their use

Abstract

Relevance The problem of meniscus injuries in children has acquired a particular relevance. The growth in their incidence has been caused not only by an active sports- and lifestyle of pediatric patients but also by improved diagnosis due to magnetic resonance and arthroscopic techniques. Aim To formulate indications for the use of various methods of meniscus suturing in children and to evaluate the results of treatment of meniscus injuries in children, depending on the location of the tears. Materials and methods Our study included 74 patients who underwent meniscus suturing from March 2018 to December 2020. The age of the children ranged from 10 to 17 years. Time since the injury ranged from one day to 3 years. Before surgery, they underwent instrumental examination; knee joint radiography was performed in all patients, knee MRI was performed in 66 patients. Results Meniscus sutures were evaluated clinically and instrumentally at 6 months after the operation (MRI). One year after the meniscus repair, X-rays of the knee were taken to assess osteoarthritis. There was no pain after surgery in 68 children (91.9 %). There were no blocks of the knee joint after surgery in all children. Full recovery of the range of motion in the knee joint was observed in 69 children (93.2 %). Complications were noted in five children. Conclusion Poor results after meniscectomy has led to the emergence of several methods that allow meniscus repair and avoid meniscectomy that impairs knee functions. In children, the potential for restoration of menisci after their reconstruction is higher than in adults. It is possible to repair lesions not only in the white zone but after periods of more than three months since the injury. The choice of the meniscus suture technique used is determined by the location of the tear, taking into account possible complications. The use of a combination of methods allows reconstruction of the damaged meniscus regardless of the location of the tear and the complexity of the injury. Good clinical results, absence of complaints and return to usual physical activities in the immediate postoperative period should be regarded as positive outcomes subjected to further study.

Keywords

• meniscus
• children
• meniscus suture
• “inside-out”
• “outside-into”
• “all inside”