Download PDF
J Knee Surg 2012; 25(05): 397-402
DOI: 10.1055/s-0032-1313752
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Suture Repair versus Arrow Repair for Symptomatic Meniscus Tears of the Knee: A Systematic Review

Olufemi Ayeni
1   Department of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Devin Peterson
1   Department of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Kevin Chan
1   Department of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Ashkan Javidan
1   Department of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
,
Rajiv Gandhi
2   Department of Orthopaedic Surgery, Toronto Western Hospital/University Health Network, Toronto, Ontario, Canada
› Author Affiliations
Further Information

Publication History

01 July 2011

27 November 2011

Publication Date:
15 May 2012 (online)

    Permissions and Reprints

Abstract

A healthy meniscus is important for normal function of the knee. Numerous studies support that the repair of a torn meniscus is important to prevent degenerative changes in the knee. The ability to repair torn menisci is based on several factors including location, tear orientation, chronicity, and concomitant ligamentous knee injuries. In this systematic review, meniscal repair technology is evaluated. Specifically, the retear rates are compared between the arrow repair and the suture repair techniques. After searching three databases (PubMed, Cochrane Central Register of Controlled Trials, and Embase) and reviewing annual meeting abstracts from the American Orthopaedic Society for Sports Medicine (2005 to 2010), four studies (two observational and two randomized controlled trials) were selected for this systematic review. Due to the limited study number and variability between studies (study design, sample population, outcome measures, and surgical technique), a meta-analysis was not performed. The overall quality of the literature was poor and thus conclusions are limited. No clear superiority of one technique was determined by this review.

Keywords

meniscus - meniscal repair
 

  • References

  • 1 Wojtys EM, Chan DB. Meniscus structure and function. Instr Course Lect 2005; 54: 323-330
    PubMedGoogle Scholar
  • 2 Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med 1982; 10 (2) 90-95
    CrossrefPubMedGoogle Scholar
  • 3 Cooper DE, Arnoczky SP, Warren RF. Meniscal repair. Clin Sports Med 1991; 10 (3) 529-548
    PubMedGoogle Scholar
  • 4 Pellacci F, Sabetta E, Galli G. Meniscus repair: cases and review of the literature. Chir Organi Mov 1995; 80 (3) 309-321
    PubMedGoogle Scholar
  • 5 Han SB, Shetty GM, Lee DH , et al. Unfavorable results of partial meniscectomy for complete posterior medial meniscus root tear with early osteoarthritis: a 5- to 8-year follow-up study. Arthroscopy 2010; 26 (10) 1326-1332
    CrossrefPubMedGoogle Scholar
  • 6 Sturnieks DL, Besier TF, Mills PM , et al. Knee joint biomechanics following arthroscopic partial meniscectomy. J Orthop Res 2008; 26 (8) 1075-1080
    CrossrefPubMedGoogle Scholar
  • 7 Walker PS, Erkman MJ. The role of the menisci in force transmission across the knee. Clin Orthop Relat Res 1975; (109) 184-192
    PubMedGoogle Scholar
  • 8 McGinty JB. Operative Arthroscopy. 3rd ed. Philadelphia, PA: Lippincott-Raven; 2003: 218-231
    Google Scholar
  • 9 American Academy of Orthopaedic Surgeons. Meniscal Tears. 2009. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00358 . Accessed July 1, 2010
    PubMedGoogle Scholar
  • 10 Lozano J, Ma CB, Cannon WD. All-inside meniscus repair: a systematic review. Clin Orthop Relat Res 2007; 455: 134-141
    CrossrefPubMedGoogle Scholar
  • 11 Farng E, Sherman O. Meniscal repair devices: a clinical and biomechanical literature review. Arthroscopy 2004; 20 (3) 273-286
    CrossrefPubMedGoogle Scholar
  • 12 Miura H, Kawamura H, Arima J , et al. A new, all-inside technique for meniscus repair. Arthroscopy 1999; 15 (4) 453-455
    CrossrefPubMedGoogle Scholar
  • 13 Bourgeois FT, Murthy S, Mandl KD. Outcome reporting among drug trials registered in ClinicalTrials.gov. Ann Intern Med 2010; 153 (3) 158-166
    CrossrefPubMedGoogle Scholar
  • 14 Bryant D, Dill J, Litchfield R , et al. Effectiveness of bioabsorbable arrows compared with inside-out suturing for vertical, reparable meniscal lesions: a randomized clinical trial. Am J Sports Med 2007; 35 (6) 889-896
    CrossrefPubMedGoogle Scholar
  • 15 Albrecht-Olsen P, Kristensen G, Burgaard P, Joergensen U, Toerholm C. The arrow versus horizontal suture in arthroscopic meniscus repair. A prospective randomized study with arthroscopic evaluation. Knee Surg Sports Traumatol Arthrosc 1999; 7 (5) 268-273
    CrossrefPubMedGoogle Scholar
  • 16 Steenbrugge F, Verdonk R, Hürel C, Verstraete K. Arthroscopic meniscus repair: inside-out technique vs. Biofix meniscus arrow. Knee Surg Sports Traumatol Arthrosc 2004; 12 (1) 43-49
    CrossrefPubMedGoogle Scholar
  • 17 Spindler KP, McCarty EC, Warren TA, Devin C, Connor JT. Prospective comparison of arthroscopic medial meniscal repair technique: inside-out suture versus entirely arthroscopic arrows. Am J Sports Med 2003; 31 (6) 929-934
    PubMedGoogle Scholar
  • 18 McGinn T, Wyer P, Wisnivesky J , et al. Clinical prediction rules. In: Guyatt G, Rennie D, Meade MO, Cook DJ, , eds. Users' Guides to the Medical Literature: Manual for Evidence-Based Clinical Practice. 2nd ed. Chapter 17.4. Columbus, OH: McGraw-Hill; 2008
    Google Scholar