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Orthopaedic Journal of Sports Medicine
By Jędrzej Lesman MD, PhD, Błażej Wójtowicz MD, PhD, Michał Kanak MD, PhD and 4 others.
Needle arthroscopy (NA) may reduce surgical trauma compared with conventional arthroscopy (CA), but evidence regarding therapeutic meniscal repair remains limited.
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To compare pain, functional outcomes, and return to work after single-implant repair of selected short medial meniscus tears using NA versus CA. Study Design: Cohort study; Level of evidence, 2.
A total of 108 patients with short, localized horizontal or flap medial meniscus tears, estimated intraoperatively at approximately 10 mm or less, were enrolled. Treatment selection followed patient preference (NA, n = 55; CA, n = 53). Two procedures planned as NA were converted to CA and analyzed according to the procedure completed. After 8 patients were lost to follow-up, 100 patients (50 per group) completed a 12-month follow-up. All repairs were performed by 1 surgeon using a single identical all-inside FiberStitch implant and a standardized rehabilitation protocol. Pain was assessed using the visual analog scale (VAS) and function using the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at 2, 6, and 12 weeks and 6 and 12 months. Return to work was also recorded.
Pain and function improved significantly over time in both groups ( P < .001). VAS scores were significantly lower after NA at 2, 6, and 12 weeks (all P < .001) and 6 months ( P < .01), with no difference at 12 months. Early differences in KOOS Pain, Symptoms, and Activities of Daily Living favored NA but remained below published minimal clinically important difference thresholds for meniscal repair. Outcomes converged at later follow-up. Return to work was faster after NA (5 vs 7 weeks; P < .001). No reoperations or clinical failures occurred.
For selected short medial meniscus tears suitable for single-implant repair, NA was associated with less early postoperative pain and faster return to work than CA, while 12-month functional outcomes were similar.
Published in Orthopaedic Journal of Sports Medicine. The abstract is shown as published and remains the work of its authors; read the full article at the source.
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