Abstract
Purpose
To report the outcomes (subjective function, return to play, complications and reoperations) of arthroscopic all-inside meniscal fixation in a large sample of soccer players with hypermobile lateral meniscus.
Methods
Between 2010 and 2015, 55 patients undergoing surgical treatment for hypermobile lateral meniscus at Mutualidad Catalana de Futbolistas (Barcelona, Spain) were identified. Patients with open physes, associated injuries, discoid meniscus, or clinical follow-up less than 6 months were excluded. Once identified, all patients were contacted over the phone to collect cross-sectional data on International Knee Documentation Committee (IKDC) score, postoperative Tegner score, and postoperative visual analogue scale (VAS) for pain. In addition, complications and reoperations were retrospectively collected.
Results
Forty-six cases (in 45 patients) with a mean (SD) age of 26.3 (9.5) years and mean (SD; range) follow-up of 43 (19.5; 8–73) months were included. The pre- and post-operative median (range) Tegner score was 9 (6–9) and 8 (0–9), respectively. Compared to the preoperative period, the postoperative Tegner score was equal in 27/46 (59%) cases and lower in 16/46 (35%) cases (3 missing values). Return to play was possible in 38/46 (82%) cases, from which 27/46 (59%) corresponded to the same pre-injury activity level. Postoperatively, the median (range) VAS for pain was 1 (0–9), and the mean (SD) subjective IKDC was 86.2 (16.7). Three of the 46 cases (6.5%) required a reoperation because of pain in one patient (meniscal suture failure) and meniscal tear in two patients.
Conclusions
All-inside meniscal fixation is a successful treatment for hypermobile lateral meniscus, which allows acceptable return to play and good function in soccer players at a low reoperation rate. However, according to the present cross-sectional case series, players should be advised that return to the same pre-injury activity level is achieved in only 27 of 46 (59%) of the cases. Surgeons facing with the difficult problem of hypermobile lateral meniscus in soccer players should consider meniscus fixation as an easy and successful option.
Level of evidence
Level IV—Therapeutic Case Series.
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The authors declare that there are no conflicts of interest for the present study.
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This study has been conducted in accordance with the ethical standards at our Institution and with the 1964 Helsinki Declaration and its later amendments.
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Supplementary material 1 Video file: intraoperative positive Tom’s aspiration test. The well positioned lateral meniscus becomes anteriorly displaced after turning the suction on through the arthroscope (WMV 6233 KB)
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Steinbacher, G., Alentorn-Geli, E., Alvarado-Calderón, M. et al. Meniscal fixation is a successful treatment for hypermobile lateral meniscus in soccer players. Knee Surg Sports Traumatol Arthrosc 27, 354–360 (2019). https://doi.org/10.1007/s00167-018-5080-6
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DOI: https://doi.org/10.1007/s00167-018-5080-6