Results with all-inside meniscal suture in pediatrics - 18/03/16

Doi : 10.1016/j.otsr.2015.12.018

A. Schmitt ^a,^b,^c,^⁎ , F. Batisse ^d , C. Bonnard ^b,^c
^a Service de Chirurgie Orthopédique et Traumatologique, CHU de Tours, avenue de la République, 37000 Tours, France
^b Service de Chirurgie Orthopédique et Traumatologique Infantile, CHU de Tours, Tours, France
^c Université François-Rabelais, Tours, France
^d Service de Chirurgie Orthopédique et Traumatologique, CHU de Poitiers, Poitiers, France

^⁎Corresponding author. Service de Chirurgie Orthopédique et Traumatologique, CHU de Tours, avenue de la République, 37000 Tours, France.

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Abstract

Introduction

Incidence of meniscal lesions is increasing in the pediatric population. Given the harmful impact of meniscectomy, meniscal repair is attempted whenever possible. The present study sought to assess the efficacy of FasT-Fix (Smith and Nephew) all-inside arthroscopic meniscal repair devices in childhood meniscal lesions. The study hypothesis was that functional results would be equivalent to those of other suture techniques.

Material and methods

Nineteen patients were assessed following arthroscopic meniscal repair, at a mean 6 years (range: 3–9 years). Mean age was 14.8 years. There was associated ACL tear in 31% of cases. Functional assessment used Lysholm, subjective IKDC, Tegner activity level and KOOS scores. Anatomic assessment of healing used MRI, arthroscopy or CT-arthrography.

Results

At last follow-up, the meniscal survival rate was 89.5% (n=17/19). Functional results were good: Lysholm: 95.7/100; subjective IKDC: 90.7/100; Tegner: 7.64. Imaging found systematic healing.

Discussion

All-inside arthroscopic meniscal suture is increasingly used in adults, and can also be implemented in children or adolescents in pediatrics. FasT-Fix (Smith and Nephew) implants, although not always easy to use, ensure a perfectly functional knee and conserve long-term meniscal chondroprotection with a low risk of complications.