Good mid‐ to long‐term outcomes after meniscus bucket‐handle tear repair: A comparative analysis with and without anterior cruciate ligament reconstruction

Author:

Pawelczyk Johannes12ORCID,Fanourgiakis Ilias1,Feil Sven1,Siebold Maja1,Kougioumtzis Ioannis1,Siebold Rainer13

Affiliation:

1. International Center for Orthopedics, ATOS Clinic Heidelberg Germany

2. Ruprecht Karl University Heidelberg Germany

3. Institute for Anatomy and Cell Biology Ruprecht Karl University Heidelberg Germany

Abstract

AbstractPurposeTo evaluate mid‐ to long‐term clinical outcomes after arthroscopic bucket‐handle meniscal tear (BHMT) repair and to assess the impact of concurrent anterior cruciate ligament reconstruction (ACLR).MethodsA comparative retrospective case series with blinded outcome assessment was conducted. All consecutive patients treated with arthroscopic BHMT repair with or without concurrent ACLR between 2001 and 2021 were eligible for inclusion. Fifty‐five patients with an average follow‐up of 7.3 ± 3.4 years were included in the analysis. Outcome measures comprised post‐operative IKDC Subjective Knee Form, Lysholm Score, Tegner Activity Scale, KOOS, and visual analogue scale (VAS) for satisfaction. Additionally, failure and reoperation rates were assessed.ResultsThe failure rate was 9%. Medial BHMT repair showed superior post‐operative IKDC scores compared to lateral meniscus repair (p = 0.038). Concurrent ACLR did not demonstrate any impact on post‐operative KOOS, IKDC, Tegner or patient satisfaction. The mean IKDC score at final follow‐up across both groups was 80.4 ± 17.8. The mean Lysholm score was 86.9 ± 16.7. Mean KOOS scores were (i) symptoms: 83.6 ± 18.3, (ii) pain: 90.2 ± 14.4, (iii) activities of daily living: 93.6 ± 15.1, (iv) sports: 78.3 ± 26.0 and (v) quality of life: 70.5 ± 24.5. Mean patient satisfaction (VAS) was 7.9 ± 2.5. The mean Tegner score was 4.9 ± 1.9. A consistent positive correlation between the number of sutures used and post‐operative outcome measures was observed but did not reach statistical significance for most items.ConclusionArthroscopic BHMT repair achieved good clinical outcomes and an acceptable failure rate of 9% at a mean follow‐up of 7 years, supporting the clinical value of meniscal repair, including large BHMTs. Concurrent ACLR showed no impact on clinical outcomes.Level of EvidenceLevel IV (retrospective case series).

Publisher

Wiley

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