Medial meniscal repair in stable knees: Survival rate and risk factors for failure at a minimum of 5 years - 29/11/23
, Azeddine Djebara b, Benjamin Freychet c, Olivier Carnessechi d, Nicolas Graveleau a, Marie-Laure Louis e, Kevin Benad f, Cesar Praz g, Gaëlle Maroteau h, Sammy Badr h, Teddy Trouillez i, Henri Favreau j, Vincent Pineau k, Sophie Putman i, land
The Francophone Arthroscopy Society (SFA)m
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Abstract |
Introduction |
The menisci play a major role in the protection of the knee against osteoarthritis. A medial meniscus (MM) tear occurring in a stable knee is more at risk of repair failure than a suture concomitant with reconstruction of the anterior cruciate ligament.
Hypothesis |
The survival of MM sutures in stable knees depends on the type of lesion.
Materials and methods |
This retrospective study was carried out as part of the 2022 Francophone Arthroscopy Society's symposium, across 10 centers (Bordeaux-Mérignac, Caen, Lille, Lille Louvière, Lyon, Marseille, Toulouse, Saint-Étienne, Strasbourg and Versailles) including medial meniscus sutures in stable knees performed before the end of 2017 (minimum 5 years of follow-up) with a collection of demographic, imaging, suture and postoperative protocol data, and a functional evaluation using the Knee injury and Osteoarthritis Outcome score (KOOS). The aim of this study was to analyze the medial meniscus sutures in stable knees and to evaluate their survival and their risk factors for failure according to the type of lesion; failure being defined by the use of a meniscectomy.
Results |
Three-hundred and sixty-seven MM sutures, including 122 bucket-handle tears, were included. The KOOS score was improved by the meniscal suture by an average of 22.2 points for each sub-score (p<0.05), with an improvement, which was more marked for the bucket-handle tears. The failure rate, defined by revision surgery by meniscectomy, was 33% on average (42% for bucket-handles tears, 26% for others). The probability of survival was reduced for bucket-handle tears (62% at 5 years versus 77% for the other types). For all lesions, the main risk factor identified for failure was immediate weight-bearing [OR=3.6 (1.62; 7.98), p=0.0016]. Smoking was a failure risk factor for bucket-handle tears [OR=5.76 (1.81; 18.35), p=0.003].
Conclusion |
MM sutures in stable knees improve knee function but present a different risk of failure depending on the type of lesion treated with a higher risk of failure for bucket-handle tears with the need for caution to be applied with regards to weight-bearing and smoking.
Level of evidence |
IV; retrospective series.
Le texte complet de cet article est disponible en PDF.Keywords : Knee, Menisci, Suture, Arthroscopy, SFA, Symposium
Plan
Vol 109 - N° 8S
Article 103681- décembre 2023 Retour au numéro
Article précédent
- The frequency of medial meniscal repairs in stable knees during one year of arthroscopic activity (2021–2022) – comparison with a retrospective study (prior to 2017)
- Marie Laure Louis, Henri Favreau, Gaelle Maroteau, Kevin Benad, César Praz, Olivier Carnessechi, Sammy Badr, Teddy Trouillez, Djebara Az-Eddine, Simon Pelletier, Benjamin Freychet, Vincent Pineau, Sophie Putman, Francophone Arthroscopy Society (SFA)
- Rehabilitation protocol after suturing the medial meniscus of a stable knee, a retrospective series of the Francophone Arthroscopy Society
- Henri Favreau, Gaelle Maroteau, César Praz, Matthieu Ehlinger, Olivier Carnesecchi, Kevin Benad, Marie-Laure Louis, Az-Eddine Djebara, Nicolas Graveleau, Benjamin Freychet, Sammy Badr, Simon Pelletier, Vincent Pineau, Sophie Putman, Francophone Arthroscopy Society (SFA)
Bienvenue sur EM-consulte, la référence des professionnels de santé.