Prospective comparison of arthroscopic medial meniscal repair technique: inside-out suture versus entirely arthroscopic arrows

BACKGROUND: Medial meniscal repairs are commonly performed with inside-out sutures and entirely arthroscopic with arrows, but few comparative evaluations on failures have been performed. HYPOTHESIS: No differences in failure rates exist between medial meniscal repairs performed with inside-out suture or entirely arthroscopic at the time of anterior cruciate ligament reconstruction. STUDY DESIGN: Prospective cohort study. MATERIALS: A single surgeon performed 47 consecutive inside-out suture repairs from August 1991 to June 1996 and 98 consecutive entirely arthroscopic repairs with arrows from June 1996 to December 1999. All data were derived from a prospective database and rehabilitation was held constant (nonweightbearing 5 weeks). Clinical success was defined as no reoperation for failed medial meniscal repair. Statistical evaluation was by Kaplan-Meier curves and Cox proportional hazards model. RESULTS: The inside-out suture group had 85% follow-up (40 of 47) with a median 68 months and the entirely arthroscopic group had 87% follow-up (85 of 98) with a median 27 months. There were seven failures in each group. Both Kaplan-Meier curves and the Cox proportional hazards model showed no difference in time to reoperation between techniques (P = 0.85). Three-year success rates (proportions with no reoperations) were 88% for sutures versus 89% for arrows. CONCLUSIONS: Repairs of the longitudinal posterior horn of the medial meniscus during an anterior cruciate ligament reconstruction with nonweightbearing for 5 weeks can be performed with an equivalent high degree of clinical success for both repair techniques.