Medium-term clinical outcome of encircled suture for repair of medial meniscus bucket-handle tear_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WU Bing ,  LU Wei ,  WANG Daping , LIU Haifeng , ZHU Weimin , OUYANG Kan , LI Hao

Department of Sports Medicine, the First Affiliated Hospital of Shenzhen University (Shenzhen Second People’s Hospital), Shenzhen Guangdong, 518000, P.R.China;

Corresponding author：

LU Wei, Email: winerl@sina.com; WANG Daping, Email: dapingwang@medmail.com.cn

Keywords：

Medial meniscus; bucket-handle tear; encircled suture; arthroscopy

DOI：

10.7507/1002-1892.201611025

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the medium-term clinical outcome of encircled suture for repair of medial meniscus bucket-handle tear (BHT). Methods Between March 2011 and June 2013, 78 patients (78 knees) with medial meniscus BHT were treated with encircled suture under arthroscopy. There were 57 males and 21 females with a mean age of 28.3 years (range, 16-39 years). The causes included sports injury in 61 cases, traffic accident injury in 12 cases, and other trauma in 5 cases. Of 78 cases, 35 were acute injury and 43 were chronic injury; 65 cases had combined injury of anterior cruciate ligament rupture. International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score were 48.2±6.3, 43.6±4.7, and 2.5±0.6, respectively. Barrett’s assessment standard, MRI, and arthroscopy examination were used for assessment of meniscus healing. IKDC score, Lysholm score, and Tegner score were used for assessment of knee function. Results Primary healing of incisions were achieved in all patients, and no complications occurred. All patients were followed up 26-63 months (mean, 42.8 months). BHT recurrence was observed in 2 patients within 1 year. Clinical healing of meniscus tear was obtained in 72 cases (92.3%) according to Barrett’s assessment standard. The IKDC score, Lysholm score, and Tegner score were significantly improved to 81.5±5.1, 86.9±3.9, and 6.2±0.5 respectively (t=–14.598,P=0.000;t=–18.478,P=0.000;t=–3.362,P=0.002). MRI results showed complete healing in 56 cases, incomplete healing in 15 cases, and unhealing in 7 cases at last follow-up, with a total healing rate of 91.0% (71/78) and a complete healing rate of 71.8% (56/78). In 21 cases undergoing arthroscopy at 18-49 months after operation, complete healing and incomplete healing were observed in 17 cases and 4 cases respectively, with a total healing rate of 100% (21/21) and a complete healing rate of 81.0% (17/21). No re-tear occurred. Conclusion Encircled suture for repair of medial meniscus BHT owns the advantage of firm suturing and good blood supply which can obtain satisfactory medium-term clinical results.

Citation： WU Bing, LU Wei, WANG Daping, LIU Haifeng, ZHU Weimin, OUYANG Kan, LI Hao. Medium-term clinical outcome of encircled suture for repair of medial meniscus bucket-handle tear. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(3): 278-283. doi: 10.7507/1002-1892.201611025 Copy

1.	Boody BS, Omar IM, Hill JA. Displaced medial and lateral bucket handle meniscal tears with intact ACL and PCL. Orthopedics, 2015, 38(8): e738-741.
2.	Pengas IP, Assiotis A, Nash W,et al. Total meniscectomy in adolescents: a 40-year follow-up. J Bone Joint Surg (Br), 2012, 94(12): 1649-1654.
3.	Ververidis AN, Verettas DA, Kazakos KJ,et al. Meniscal bucket handle tears: a retrospective study of arthroscopy and the relation to MRI. Knee Surg Sports Traumatol Arthrosc, 2006, 14(4): 343-349.
4.	Unay K, Akcal MA, Gokcen B,et al. The relationship between intra-articular meniscal, chondral, and ACL lesions: finding from 1, 774 knee arthroscopy patients and evaluation by gender. Eur J Orthop Surg Traumatol, 2014, 24(7): 1255-1262.
5.	Aydingöz U, Firat AK, Atay OA,et al. MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification. Eur Radiol, 2003, 13(3): 618-625.
6.	Cetik O, Cirpar M, Eksioglu F,et al. Simultaneous bucket handle tear of both medial and lateral menisci of a knee with chronic anterior cruciate ligament deficiency. Knee Surg Sports Traumatol Arthrosc, 2006, 14(4): 356-359.
7.	Wright J, Tamura C, Findlay I,et al. Simultaneous bicompartmental bucket handle meniscal tears with a clinically competent Anterior Cruciate Ligament. J Orthop Surg Res, 2010, 5: 68.
8.	冯华, 洪雷, 耿向苏, 等. 半月板大桶柄样撕裂的关节镜下联合修补技术. 中国运动医学杂志, 2007, 26(1): 10-16.
9.	Zaffagnini S, Signorelli C, Bonanzinga T,et al. Does meniscus removal affect ACL-deficient knee laxity? Anin vivo study. Knee Surg Sports Traumatol Arthrosc, 2016, 24: 3599-3604.
10.	解新刚, 杨惠光, 姜雪锋, 等. 关节镜下联合修补技术治疗内侧半月板桶柄样撕裂. 交通医学, 2009, 23(4): 344-346.
11.	胡力, 宋斌, 叶英文, 等. 关节镜下治疗半月板桶柄状撕裂的近期疗效观察. 中华关节外科杂志(电子版), 2011, 5(2): 22-24.
12.	李强, 高志, 程松苗, 等. 缝合治疗在膝关节内侧半月板桶柄状撕裂中的应用及效果. 华西医学, 2013, 28(8): 1203-1206.
13.	Barrett GR, Treacy SH, Ruff CH. Preliminary results of the T-fix endoscopic meniscus technique in an anterior cruciate ligament reconstruction population. Arthroscopy, 1997, 13(2): 218-223.
14.	Sanders TG, Miller MD. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the knee. Am J Sports Med, 2005, 33(1): 131-148.
15.	Ahn JH, Lee YS, Yoo JC,et al. Clinical and second-look arthroscopic evaluation of repaired medial meniscus in anterior cruciate ligament-reconstructed knees. Am J Sports Med, 2010, 38(3): 472-477.
16.	黄东红, 卢启贵, 王平, 等. 关节镜下双面立体缝合修复半月板桶柄状撕裂的中期疗效. 中国修复重建外科杂志, 2015, 29(2): 163-166.
17.	Meister K, Indelicato PA, Spanier S,et al. Histology of the torn meniscus: a comparison of histologic differences in meniscal tissue between tears in anterior cruciate ligament-intact and anterior cruciate ligament-deficient knees. Am J Sports Med, 2004, 32(6): 1479-1483.
18.	de Campos GC, Nery W Jr, Teixeira PE,et al. Association between meniscal and chondral lesions and timing of anterior cruciate ligament reconstruction. Orthop J Sports Med, 2016, 4(10): 1-6.
19.	Di Giancamillo A, Mangiavini L, Tessaro I,et al. The meniscus vascularization: the direct correlation with tissue composition for tissue engineering purposes. J Biol Regul Homeost Agents, 2016, 30(4 Suppl 1): 85-90.
20.	Fox AJ, Wanivenhaus F, Burge AJ,et al. The human meniscus: a review of anatomy, function, injury, and advances in treatment. Clin Anat, 2015, 28(2): 269-287.

1. Boody BS, Omar IM, Hill JA. Displaced medial and lateral bucket handle meniscal tears with intact ACL and PCL. Orthopedics, 2015, 38(8): e738-741.
2. Pengas IP, Assiotis A, Nash W,et al. Total meniscectomy in adolescents: a 40-year follow-up. J Bone Joint Surg (Br), 2012, 94(12): 1649-1654.
3. Ververidis AN, Verettas DA, Kazakos KJ,et al. Meniscal bucket handle tears: a retrospective study of arthroscopy and the relation to MRI. Knee Surg Sports Traumatol Arthrosc, 2006, 14(4): 343-349.
4. Unay K, Akcal MA, Gokcen B,et al. The relationship between intra-articular meniscal, chondral, and ACL lesions: finding from 1, 774 knee arthroscopy patients and evaluation by gender. Eur J Orthop Surg Traumatol, 2014, 24(7): 1255-1262.
5. Aydingöz U, Firat AK, Atay OA,et al. MR imaging of meniscal bucket-handle tears: a review of signs and their relation to arthroscopic classification. Eur Radiol, 2003, 13(3): 618-625.
6. Cetik O, Cirpar M, Eksioglu F,et al. Simultaneous bucket handle tear of both medial and lateral menisci of a knee with chronic anterior cruciate ligament deficiency. Knee Surg Sports Traumatol Arthrosc, 2006, 14(4): 356-359.
7. Wright J, Tamura C, Findlay I,et al. Simultaneous bicompartmental bucket handle meniscal tears with a clinically competent Anterior Cruciate Ligament. J Orthop Surg Res, 2010, 5: 68.
8. 冯华, 洪雷, 耿向苏, 等. 半月板大桶柄样撕裂的关节镜下联合修补技术. 中国运动医学杂志, 2007, 26(1): 10-16.
9. Zaffagnini S, Signorelli C, Bonanzinga T,et al. Does meniscus removal affect ACL-deficient knee laxity? Anin vivo study. Knee Surg Sports Traumatol Arthrosc, 2016, 24: 3599-3604.
10. 解新刚, 杨惠光, 姜雪锋, 等. 关节镜下联合修补技术治疗内侧半月板桶柄样撕裂. 交通医学, 2009, 23(4): 344-346.
11. 胡力, 宋斌, 叶英文, 等. 关节镜下治疗半月板桶柄状撕裂的近期疗效观察. 中华关节外科杂志(电子版), 2011, 5(2): 22-24.
12. 李强, 高志, 程松苗, 等. 缝合治疗在膝关节内侧半月板桶柄状撕裂中的应用及效果. 华西医学, 2013, 28(8): 1203-1206.
13. Barrett GR, Treacy SH, Ruff CH. Preliminary results of the T-fix endoscopic meniscus technique in an anterior cruciate ligament reconstruction population. Arthroscopy, 1997, 13(2): 218-223.
14. Sanders TG, Miller MD. A systematic approach to magnetic resonance imaging interpretation of sports medicine injuries of the knee. Am J Sports Med, 2005, 33(1): 131-148.
15. Ahn JH, Lee YS, Yoo JC,et al. Clinical and second-look arthroscopic evaluation of repaired medial meniscus in anterior cruciate ligament-reconstructed knees. Am J Sports Med, 2010, 38(3): 472-477.
16. 黄东红, 卢启贵, 王平, 等. 关节镜下双面立体缝合修复半月板桶柄状撕裂的中期疗效. 中国修复重建外科杂志, 2015, 29(2): 163-166.
17. Meister K, Indelicato PA, Spanier S,et al. Histology of the torn meniscus: a comparison of histologic differences in meniscal tissue between tears in anterior cruciate ligament-intact and anterior cruciate ligament-deficient knees. Am J Sports Med, 2004, 32(6): 1479-1483.
18. de Campos GC, Nery W Jr, Teixeira PE,et al. Association between meniscal and chondral lesions and timing of anterior cruciate ligament reconstruction. Orthop J Sports Med, 2016, 4(10): 1-6.
19. Di Giancamillo A, Mangiavini L, Tessaro I,et al. The meniscus vascularization: the direct correlation with tissue composition for tissue engineering purposes. J Biol Regul Homeost Agents, 2016, 30(4 Suppl 1): 85-90.
20. Fox AJ, Wanivenhaus F, Burge AJ,et al. The human meniscus: a review of anatomy, function, injury, and advances in treatment. Clin Anat, 2015, 28(2): 269-287.

Chinese Journal of Reparative and Reconstructive Surgery

Medium-term clinical outcome of encircled suture for repair of medial meniscus bucket-handle tear

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content