Document Detail


Healing results of meniscal tears left in situ during anterior cruciate ligament reconstruction: a review of clinical studies.
MedLine Citation:
PMID:  19183957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The presence of peripheral meniscal tears is common at the time of anterior cruciate ligament (ACL) reconstruction. Techniques to preserve the maximum amount of meniscal tissue include "non operative" management (tear left alone, without repair or removal), meniscus repair, partial meniscectomy. There is a lack of consensus guidelines about the management of peripheral stable meniscal tears. When to remove, let alone or repair? We performed an evidence-based review of the outcomes of stable meniscal tears left in situ during ACL surgery, in order to assess the effectiveness of this popular procedure. Clinical and anatomical results (arthrography or second look arthroscopy) were analyzed. Our literature search yielded ten relevant studies (9 level IV, 1 level III). The mean time of follow-up was 16 months. Pain or mechanical symptoms related to the medial tibiofemoral joint were reported in 0-66% of cases. Subsequent medial meniscectomy or repair were performed in 0-33% of cases. Pain or mechanical symptoms related to the lateral tibiofemoral joint were reported in 0-18% cases. Subsequent lateral meniscectomy or repair were performed in 0-22% cases. A complete healing occurred in 50-61% cases for the medial meniscus and in 55-74% cases for the lateral meniscus. No definite conclusion can be made with regard to these results. The conservative approach is more effective for lateral menisci. The rate of bad results for the medial meniscus remains high when a conservative treatment is used. For the medial meniscus, repair of stable peripheral tears may be always indicated to decrease the risk of postoperative pain or subsequent meniscectomy.
Authors:
Nicolas Pujol; Philippe Beaufils
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-01-31
Journal Detail:
Title:  Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA     Volume:  17     ISSN:  1433-7347     ISO Abbreviation:  Knee Surg Sports Traumatol Arthrosc     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-07-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9314730     Medline TA:  Knee Surg Sports Traumatol Arthrosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  396-401     Citation Subset:  IM    
Affiliation:
Orthopaedic Department, Hopital Andre Mignot, 177, rue de Versailles, 78157 Le Chesnay, France. nicolaspujol1@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Anterior Cruciate Ligament / surgery*
Arthroscopy / methods*
Evidence-Based Medicine
Humans
Knee Joint / surgery
Menisci, Tibial / injuries*
Reconstructive Surgical Procedures / methods*
Rupture
Wound Healing*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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