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The American Journal of Sports Medicine 31:929-934 (2003)
© 2003 American Orthopaedic Society for Sports Medicine

Prospective Comparison of Arthroscopic Medial Meniscal Repair Technique

Inside-Out Suture Versus Entirely Arthroscopic Arrows

Kurt P. Spindler, MD*,{dagger}, Eric C. McCarty, MD*, Todd A. Warren, NP, ATC*, Clinton Devin, MD* and Jason T. Connor, MS{ddagger}

* Vanderbilt Sports Medicine Center, Department of Orthopaedics and Rehabilitation, Nashville, Tennessee, {ddagger} Department of Biostatistics & Epidemiology, The Cleveland Clinic Foundation, Cleveland, Ohio

{dagger} Address correspondence and reprint requests to Kurt P. Spindler, MD, Vanderbilt Sports Medicine Center, 2601 Jess Neely Drive, Nashville, TN 37212

Background: Medial meniscal repairs are commonly performed with inside-out sutures and entirely arthroscopic with arrows, but few comparative evaluations on failures have been performed.

Hypothesis: No differences in failure rates exist between medial meniscal repairs performed with inside-out suture or entirely arthroscopic at the time of anterior cruciate ligament reconstruction.

Study Design: Prospective cohort study.

Materials: A single surgeon performed 47 consecutive inside-out suture repairs from August 1991 to June 1996 and 98 consecutive entirely arthroscopic repairs with arrows from June 1996 to December 1999. All data were derived from a prospective database and rehabilitation was held constant (nonweightbearing 5 weeks). Clinical success was defined as no reoperation for failed medial meniscal repair. Statistical evaluation was by Kaplan-Meier curves and Cox proportional hazards model.

Results: The inside-out suture group had 85% follow-up (40 of 47) with a median 68 months and the entirely arthroscopic group had 87% follow-up (85 of 98) with a median 27 months. There were seven failures in each group. Both Kaplan-Meier curves and the Cox proportional hazards model showed no difference in time to reoperation between techniques (P = 0.85). Three-year success rates (proportions with no reoperations) were 88% for sutures versus 89% for arrows.

Conclusions: Repairs of the longitudinal posterior horn of the medial meniscus during an anterior cruciate ligament reconstruction with nonweightbearing for 5 weeks can be performed with an equivalent high degree of clinical success for both repair techniques.




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