Repair of Meniscal Tears by the All-Inside Polylactic Acid Meniscal Arrow

Abstract

The objective of meniscal repair is to prevent the early onset of osteoarthritis and alleviate the symptoms of a torn meniscus.  In order to minimize the risk of neurovascular damage when repairing posterior and lateral horn tears of the meniscus, an all-inside arthroscopic surgical technique has been developed using a polylactic acid (PLA) tack as a bioabsorbable "meniscal arrow".  This paper is a retrospective study that evaluates the efficacy of this technique.  Post-operative evaluation was performed by chart review and surveys with respect to knee function (Lysholm Scale), activity level (Tegner Activity Scale), and patient quality of life (Medical Outcomes Survey, Short Form-36).  Clinical evaluation showed that 12 of 13 patients had successful repair by this technuque.  Eight patients had normal range-of-motion (ROM), three were restricted, and two were unrecorded.  Surveys were completed by 8 of 13 patients.  Six of eight survey respondents returned to pre-injury levels of sport activity.  Mean scores of the eight survey respondents on the Short Form-36 showed slightly lower than average values for Physical Functioning (PF), Role-Physical (RP), and Bodily Pain (BP);  however, General Health (GH), Vitality (VT), Social Functioning (SF), Role-Emotinal (RE), and Mental Health (MH) scores were above average.  All study values were within 1.2 SD of the norm.  Quality of life did not appear to be affected.  Seven of eight survey respondents reported slight impairment while squatting.  The all-inside meniscal arrow repair technique was effective and appropriate in repairing meniscal tears of the knee.  Unfortunately, difficulty in squatting and restriction of ROM are two sequelae that may occur post-operatively.