Prognostic factors for complex meniscal repair failure

Abstract

Background: Meniscal repair is indicated for complex meniscal tears, but the reported failure rate for repair is 5.8%. Purpose: This study aimed to explore prognostic factors for complex meniscal repair failure. Methods: This retrospective study included 69 meniscal repair procedures, with (52.2%) or without ligament tears, and arthroscopic technique using the FasT-Fix system (Smith & Nephew Endoscopy, Andover, MA, USA) for the meniscal tear. Preoperative variables were age, sex, and smoking status. Sports activities were categorized as pivot sports (tennis, baseball), basketball, badminton, running, nonspecific sport, or no sport. Other variables were time from trauma to surgery (months) and body mass index ＞ 25 (kg/m^2). Intraoperative variables were lesion site (affected leg, meniscus, and horn), suture number, torn size, associated ligament tear (anterior, posterior, and medical cruciate and lateral collateral ligaments or a combination), associated chondropathy, and existence of contralateral meniscal tear. Failure was mainly defined by symptomatic re-tear of the same site of a previous meniscal lesion and was assessed by the postoperative Lysholm score. Results: At follow-up after a mean of 29 months, 4 failures were reported (5.8%). Age analyzed as a linear model (p = 0.034, univariate analysis; p = 0.019, multivariate analyses), age older than 40 years (p = 0.005, univariate analysis), and tear of both medial and lateral (p = 0.003, univariate analysis) emerged as significant factors for poor prognoses. Conclusion: Epidemiological and lesion-related factors mentioned in this case did not influence the symptomatic re-tear rate after complex meniscal repair. However, tears due to aging and bilateral meniscus tears emerged as predictors of poor outcomes of complex meniscal repair. Age was probably a significant factor because of the better healing potential of a complex meniscus tear in younger patients.