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Arthroscopic Repair of Meniscal Tears Extending into the Avascular Zone in Patients Younger Than Twenty Years of Age

Frank R. Noyes, MD^, and Sue D. Barber-Westin

Cincinnati Sportsmedicine and Orthopaedic Center and the Deaconess Hospital, Cincinnati, Ohio

Presented at the interim meeting of the AOSSM, San Francisco, California, March 2001.

Address correspondence and reprint requests to Frank R. Noyes, MD, Cincinnati Sportsmedicine Research and Education Foundation, Deaconess Hospital, 311 Straight Street, Cincinnati, OH 45219

Background: Limited data are available regarding repair results of meniscal tears extending into the central avascular region.

Hypothesis: Meniscal tears extending into the avascular region can be successfully repaired in patients less than 20 years old.

Study Design: Prospective cohort study.

Methods: We examined the results of 71 meniscal repairs (64 knees) for tears extending into the central avascular region in patients 19 years of age or younger; 67 were examined clinically (mean, 51 months after surgery) and 36, by follow-up arthroscopy (mean, 18 months).

Results: In 53 of 71 (75%) meniscal repairs patients had no tibiofemoral compartment symptoms and there were no clinical failures. In 18 (25%) meniscal repairs, patients showed tibiofemoral symptoms or a failed repair was detected on follow-up arthroscopy. In the subgroup of 45 knees with meniscal repair and anterior cruciate ligament reconstruction evaluated clinically, 39 (87%) patients rated their knee as normal or very good, 2 (4%) as good, 3 (7%) as fair, and 1 (2%) as poor.

Conclusions: A stable repair of complex meniscal tears that extend into the avascular region can be obtained using a meticulous inside-out vertical divergent suture technique. We recommend repair, particularly in young active patients in whom removal of complex tears would result in major loss of meniscal function and the risk of future arthrosis.

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