Prospective cohort study comparing two all-inside meniscus repair technique in repair of 'RAMP' lesion

Abstract

Introduction: Ramp lesions are longitudinal tears of the posterior horn of the medial meniscus. The classic repair method is an all-inside technique within the posterior-medial compartment using a suture hook. The reported healing rate is high (89%-95%), but the learning curve is steep. All-inside repair using pre-loaded suture anchor (eg, Fastfix) is technically simpler and faster. However, it is not reported whether the healing rate after Fastfix-repair of ramp lesion is comparable to that of the classic suture-hook method. Methods: A prospective cohort study was carried out to investigate the difference in the healing rate of repair of ramp lesion between these two techniques. The choice of method of meniscus repair was not randomised. Reassessment magnetic resonance imaging were performed at a minimum of 1 year after the index operation. Primary outcome assessed was rate of healing. Secondary outcome was incidence of repeated meniscus operation. Results: A total of 76 patients were recruited (38 suture-hook repair, 38 Fastfix-repair). The mean follow-up was 49 (range, 12-118) months in the suture-hook group and 65 (range, 18-115) months in the Fastfix-repair group. Patients were 65 men and 11 women with mean age 27 (range, 18-56) years. The incidence of failed healing on reassessment magnetic resonance imaging was 14% in suture-hook group and 18% in Fastfix-repair group. The rate of repeated meniscus operation was 6% and 11%, respectively. Conclusion: The healing rate of repaired ramp lesion was high (82%-86%) and was probably not dependent on the technique used.