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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ESecond-generation suture-based devices for meniscal repair appear to have overcome some of the complications associated with first-generation all-inside designs, but there have been no outcome studies of these second-generation systems beyond 3 years. This article discusses the results of a retrospective review of 83 consecutive meniscus repairs (either isolated or combined with anterior cruciate ligament reconstruction [ACLR]), which reported an 84% success rate with a second-generation all-inside repair system at a minimum of a 5-year follow-up.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ESports Medicine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHip \u0026amp; Knee Conditions\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ESecond-generation suture-based devices for meniscal repair appear to have overcome some of the complications associated with first-generation all-inside designs, but there have been no outcome studies of these second-generation systems beyond 3 years. Ljiljana Bogunovic, MD, Washington University in St. Louis, St. Louis, Missouri, USA, discussed the results of a retrospective review of 83 consecutive meniscus repairs (either isolated or combined with anterior cruciate ligament reconstruction [ACLR]), which reported an 84% success rate with a second-generation all-inside repair system at a minimum of a 5-year follow-up. The success of the repair was similar for isolated repairs and for those performed in conjunction with ACLR. Patient age or sex did not affect the outcome.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPatients were identified by billing records as well as the Multicenter Orthopedic Outcomes Network database. A single sports-fellowship-trained surgeon using the FasT-Fix all-inside repair device performed the repairs arthroscopically. Sutures were placed until the desired stability was achieved. All tears were either longitudinal or bucket-handle in orientation, and involved either the red\/red or red\/white meniscal zones. Patients with isolated tears were weight bearing as tolerated in a knee immobilizer for 6 weeks postoperatively. Patients with combined ACLR were weight bearing as tolerated without bracing. \u003Cem\u003EFailure\u003C\/em\u003E was defined as repeat surgical intervention requiring revision, repair, or resection. Failure information was obtained by telephone interview and chart review after a minimum of 5 years. Patient-reported outcomes were assessed using Knee Injury and Osteoarthritis Outcome Scores (KOOS), International Knee Documentation Committee (IKDC) Subjective Knee Form scores, and Marx activity scores.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAverage follow-up at 7 years (range, 5 to 13) was obtained for 90% of the 81 patients (mean age, 27 years; range, 14 to 54 years). Within the final cohort, there were 26 isolated repairs and 49 repairs combined with ACLR. \u003Cem\u003ETime to failure\u003C\/em\u003E was defined as the interval between index meniscal repair and repeat repair or meniscectomy.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EFailed meniscal repairs were noted in 16% (n = 12) of the total cohort at a mean of 47 months (range, 15 to 95). Similar failure rates were noted for medial (18%) and lateral (8.0%) meniscal repairs (p = .744). Isolated repairs failed at a rate of 11.5% (95% CI, \u2013.76 to 23.75) compared with 18.3% (95% CI, 7.5 to 29.1; p = .526) for the combined procedure. Individual failure rates are shown in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E. Patient age, sex, number of sutures, length of follow-up, or type of procedure (isolated vs combined) did not affect the meniscal failure rate.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/14875\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/14875\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14875\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EMeniscus Failure Rate After Mean of 5 Years\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EPostoperative KOOS and IKDC scores were similar between the isolated and combined treatment groups. Marx activity scores were significantly (p = .03) higher in patients having isolated meniscus repair compared with those having both meniscus repair and ACLR.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThis study is limited by its retrospective nature, a definition of \u003Cem\u003Emeniscal failure\u003C\/em\u003E that may underestimate true repair failure, and possible insufficient patient numbers to detect a difference between isolated repairs and those performed with ACLR. Despite this, it is apparent that second-generation all-inside meniscal repair devices improved long-term (\u0026gt; 5 years) failure rates compared with first-generation repair devices and were equal to those of inside-out, out-side-in, and open repairs. Equivalent long-term failure rates were also noted with isolated repairs compared with repairs performed with concurrent ACLR. Meniscal repair with a second-generation all-inside repair system is a reliable technique with good longevity.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/20.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzoxa1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzoxa1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}