Comparison of Subsequent Surgery After Repair in Bucket-Handle Meniscal Tears and Meniscectomy Analysis of a Large, Contained Cohort Study.

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Abstract

Conflict of interest statement: One or more of the authors has declared the following potential conflict of interest or source of funding: Research support was received from Kaiser Foundation Community Benefits Grant. M.W.H. has received education payments from Evolution Surgical. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Kaiser Permanente Northern California (ref No. 00001045). 8. Cureus. 2023 Jan 2;15(1):e33270. doi: 10.7759/cureus.33270. eCollection 2023 Jan. Meniscal Injuries in Patients Aged 40 Years or Older: A Comparative Study Between Meniscal Repair and Partial Meniscectomy. Ventura M(1), Seabra P(1), Oliveira J(1), Sousa P(1), Quesado M(1), Sousa H(1), Pereira R(1), Costa A(1), Carvalho P(1). Author information: (1)Orthopaedics and Traumatology, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, PRT. Introduction Meniscal tears represent one of the most frequent knee injuries and are the most common cause of knee surgery. Historically, age has been considered an independent factor contraindicating meniscal repair due to the assumption that meniscal injuries in this population are frequently chronic tears, mostly with a degenerative tear pattern, and low healing potential. However, recent literature has questioned this paradigm with studies reporting successful outcomes with meniscal repair in older patients. Our study aimed to evaluate and compare the short-term clinical outcomes of meniscal repair versus partial meniscectomy in patients aged ≥40 years old. Methods A retrospective study was conducted that included patients over the age of 40 years, diagnosed with meniscal tears, that underwent arthroscopically assisted meniscal repair or partial meniscectomy between 01 January and 31 December 2020. The patients were divided into two groups: Group 1- partial meniscectomy (PM) and Group 2- meniscal repair (MR). The clinical evaluation was performed 24 months after the surgery, and the studied variables were: function (Tegner Lysholm Knee Scoring Scale), pain (Visual Analogue Scale), patient satisfaction, and failure rate.  Results Fifty-one patients met the inclusion criteria, and 7 were excluded due to loss of follow-up during telephone contact. Thus, the final sample consisted of 44 patients (mean age 52.18y), both groups with 22 patients. In both groups, we found an improvement in pain 2 years after the surgery, with a decrease in the VAS value between the pre and post-surgery. On average, the VAS score decreased from 7.9 to 4.5 in the group subjected to partial meniscectomy, and from 7.5 to 3.2 in the meniscal repair. This was statistically significant in both groups, with a p-value