Clinical Study Of Arthroscopic Meniscus Repair Using Rapid Loc Device

Objective: To observe and compare the short-time and middle-time outcomeof arthroscopic meniscal repair using Inside-out techniques and Rapid Loc device. To offer the consults for the clinical evaluation when repairing the meniscal lesions with Rapid Loc device after comparing their advantage and disadvantage .Methods: The inclusion criteria and exclusion criteria were worked out. According to the criteria, 38 cases with meniscal lesions who underwent arthroscopic meniscal repair using Inside-out techniques (Arthrex Company, USA) and Rapid Loc device (Mitek Worldwide Westwood, MA) were enrolled in the study between June 1 2003 and February 31 2006. The patients' data of illness and outcomes of follow-up from 6 to 26 months, such as preoperative state of the illness including age, sex, course of diseases, location of the meniscal tears, length of tears, breadth between tears and connection of the meniscus to synovial membrane, preoperative Lyscholm score, operation time, the healing rate of meniscus (Barrett' s criteria) , the percentage of complications and the functional restoration of the knee (Lyscholm score), were retrospectively analyzed . Firstly, the homogeneousness of the preoperative state of the illness were analyzed with the Stata 7.0 statistical package, then the difference of the patients' the time required for meniscal repair, the healing rate (Barrett's criteria), the percentage of complications and the functional restoration of the knee (Lyscholm score) were distinguished between the two groups if they had the comparability. Their advantage and disadvantage, the short-time and middle-time outcome of the two methods were further assessed.Results: The patients' age, sex, course of diseases, position of the meniscal tears, length of tears, breadth between tears and connection of the meniscus to synovial membrane, preoperative Lyscholm score have no diffence between group of Rapid Loc device and group of inside-out technique, that is, the patients' preoperative state of the illness are homogeneous and comparable. The operation time is significantly different between the two groups, i. e. the time required for meniscal repair with Rapid Loc device (mean 25 min)is shorter than that with inside-out technique (mean 47 min). Lyscholm score of the two groups shows a significant improvement from pre-operation to post-operation respectively, there is statistically difference, namely, the two techniques can equally improve the function of the knee. The healing rate, the percentage of complications and the functional restoration of the knee have no significant differences between the two groups, that is, the curative effect is same between the two techniques. Conclusion: The arthroscopic meniscal repair using Rapid Loc device or Inside-out techniques can equally heal the meniscal lesion. The healing rate is higher (83. 3%～85%) and the function of the knee is improved. The operation time using Rapid Loc device is shorter than that using Inside-out technique. The short-time and middle-time outcome of the two techniques is same. Operative procedure of arthroscopic meniscal repair using Rapid Loc device is simpler and has less hurt and can significantly improve the function of the knee. It is fit for the meniscal repair of posterior lesions and is superior to Inside-out technique for the treatment of posterior meniscal lesions. It deserves to be popularized and applied in clinic.Scientific significance: The biomechanics and cadaveric study of Miller MD, Diduch DR and Zantop T showed that operative procedure of arthroscopic meniscal repair using Rapid Loc device was simple, safe, accurate, the device was fit for the meniscal repair of posterior lesions and decreased the chance for chondral abrasion. However, no clinical results were currently available comparing the gold standard. The results of the study will offer the reference and theoretical basis for the clinical evaluation of arthroscopic meniscal repair using Rapid Loc device and promote the development of the arthroscopic meniscal repair technique.