Journal List > J Korean Orthop Assoc > v.44(3) > 1012909

Song and Ha: Clinical Results of the Accelerated Rehabilitation Program after Meniscal Repair using the RapidLoc Device

Abstract

Purpose

The purpose of this study was to evaluate the clinical results of the accelerated rehabilitation program after performing meniscal repair using the RapidLoc device, and we wanted to investigate the incidence of complications related to using the RapidLoc device together with the accelerated rehabilitation program.

Materials and Methods

We performed a retrospective review of a consecutive series of meniscal repairs that were done by single surgeon with using the RapidLoc meniscal repair device. An accelerated postoperative rehabilitation program followed, and this was independent of whether anterior cruciate ligament (ACL) surgery was also performed. The Lysholm and IKDC (International Knee Documentation Committee) activity scores, the clinical examination findings and the adverse events were recorded for all the patients. In addition, using Barrett's criteria, a repaired meniscus was considered healed if there was no joint line tenderness, effusion or a negative McMurray's test at the latest follow-up.

Results

At follow-up, the mean IKDC activity score was 3.38 (1.75 preoperatively), the Lysholm score was 91.8 (48.7 preoperatively). Clinical success occurred for 30 repairs (93.7%) at the time of the last follow-up. Two patient had tenderness on joint line palpation and intermittent effusion, so theses repair were considered failure according to our criteria. There was no specific complication related to the RapidLoc device.

Conclusion

Our results show that accelerated rehabilitation program after arthroscopic meniscal repair with using the RapidLoc device provided a high rate of clinical meniscus healing and this appeared to be safe and effective.

Figures and Tables

Fig. 1
The RapidLoc device is composed of 3 elements: the "Top-hat", the suture which has a sliding knot, and the "Backstop".
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Fig. 2
(A) Penetrate the meniscus with the delivery needle until abuts the meniscus. (B) Pull the trigger mechanism to deliver the "Backstop" to the periphery of the meniscus. (C) Withdraw the needle and then pull on the suture limb and advance the slinding knot and the "Top-hat" to the meniscal tissue using knot pusher. (D) Adjust the tension and then cut the free end of the suture.
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Table 1
Accelerated Rehabilitation Protocol after Meniscus Repair
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References

1. Albrecht-Olsen P, Kristensen G, Törmälä P. Meniscus bucket-handle fixation with an absorbable Biofix tack: development of a new technique. Knee Surg Sports Traumatol Arthrosc. 1993. 1:104–106.
crossref
2. Allen PR, Denham RA, Swan AV. Late degenerative changes after meniscectomy. Factors affecting the knee after operation. J Bone Joint Surg Br. 1984. 66:666–671.
crossref
3. Anderson K, Marx RG, Hannafin J, Warren RF. Chondral injury following meniscal repair with a biodegradable implant. Arthroscopy. 2000. 16:749–753.
crossref
4. Andersson-Molina H, Karlsson H, Rockborn P. Arthroscopic partial and total meniscectomy: a long-term follow-up study with matched controls. Arthroscopy. 2002. 18:183–189.
5. Asik M, Sen C, Erginsu M. Arthroscopic meniscal repair using T-fix. Knee Surg Sports Traumatol Arthrosc. 2002. 10:284–288.
crossref
6. Barber FA. Accelerated rehabilitation for meniscus repairs. Arthroscopy. 1994. 10:206–210.
crossref
7. Barber FA, Coons DA, Ruiz-Suarez M. Meniscal repair with the RapidLoc meniscal repair device. Arthroscopy. 2006. 22:962–966.
crossref
8. Barrett GR, Field MH, Treacy SH, Ruff CG. Clinical results of meniscus repair in patients 40 years and older. Arthroscopy. 1998. 14:824–829.
crossref
9. Barrett GR, Treacy SH, Ruff CG. Preliminary results of the T-fix endoscopic meniscus repair technique in an anterior cruciate ligament reconstruction population. Arthroscopy. 1997. 13:218–223.
crossref
10. Bowen TR, Feldmann DD, Miller MD. Return to play following surgical treatment of meniscal and chondral injuries to the knee. Clin Sports Med. 2004. 23:381–393.
crossref
11. Gill SS, Diduch DR. Outcomes after meniscal repair using the meniscus arrow in knees undergoing concurrent anterior cruciate ligament reconstruction. Arthroscopy. 2002. 18:569–577.
crossref
12. Hantes ME, Zachos VC, Varitimidis SE, Dailiana ZH, Karachalios T, Malizos KN. Arthroscopic meniscal repair: a comparative study between three different surgical techniques. Knee Surg Sports Traumatol Arthrosc. 2006. 14:1232–1237.
crossref
13. Hurel C, Mertens F, Verdonk R. Biofix resorbable meniscus arrow for meniscal ruptures: results of a 1-year follow-up. Knee Surg Sports Traumatol Arthrosc. 2000. 8:46–52.
14. Hutchinson MR, Ash SA. Failure of a biodegradable meniscal arrow. A case report. Am J Sports Med. 1999. 27:101–103.
15. Kotsovolos ES, Hantes ME, Mastrokalos DS, Lorbach O, Paessler HH. Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Arthroscopy. 2006. 22:3–9.
crossref
16. Laprell H, Stein V, Petersen W. Arthroscopic all-inside meniscus repair using a new refixation device: a prospective study. Arthroscopy. 2002. 18:387–393.
17. Mariani PP, Santori N, Adriani E, Mastantuono M. Accelerated rehabilitation after arthroscopic meniscal repair: a clinical and magnetic resonance imaging evaluation. Arthroscopy. 1996. 12:680–686.
crossref
18. Morgan CD, Wojtys EM, Casscells CD, Casscells SW. Arthroscopic meniscal repair evaluated by second-look arthroscopy. Am J Sports Med. 1991. 19:632–637.
crossref
19. Petsche TS, Selesnick H, Rochman A. Arthroscopic meniscus repair with bioabsorbable arrows. Arthroscopy. 2002. 18:246–253.
crossref
20. Quinby JS, Golish SR, Hart JA, Diduch DR. All-inside meniscal repair using a new flexible, tensionable device. Am J Sports Med. 2006. 34:1281–1286.
crossref
21. Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP. Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med. 1995. 23:240–244.
crossref
22. Ross G, Grabill J, McDevitt E. Chondral injury after meniscal repair with bioabsorbable arrows. Arthroscopy. 2000. 16:754–756.
crossref
23. Shelbourne KD, Patel DV, Adsit WS, Porter DA. Rehabilitation after meniscal repair. Clin Sports Med. 1996. 15:595–612.
24. Song EK, Lee KB, Yoon TR. Aseptic synovitis after meniscal repair using the biodegradable meniscus arrow. Arthroscopy. 2001. 17:77–80.
crossref
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