Postoperative Outcome And Risk Factors For Arthroscopically Repaired Bucket-handle Medial Meniscal Tears

Objective The goal of this retrospective study was to analyze the clinical results and the factors affecting clinical outcomes of arthroscopically repaired bucket-handle medial meniscal tears.Methods A total of 87 patients underwent arthroscopic repair for bucket-handle medial meniscal tears between 2017 and 2019.The average follow-up was 18 months(range,6 to36 months).Factors included age,gender,body mass index,affected side,tear mechanism,competition level,smoking status,mechanical locking,time from injury to surgery,tear length,tear width,concurrent anterior cruciate ligament reconstruction and recurrent instability were collected.Pre-and postoperative functional status was assessed using physical examinations with Lysholm,Tegner and International Knee Documentation Committee(IKDC)scores.Postoperative healing was assessed with the clinical criteria of Barrett et al and the radiologic assessment method of MRI.The data was analyzed statistically with univariate analysis by SPSS 24.0 software.The factors with statistical difference between the two groups were further bring into the logistic regression model and to screen the independent risk factors for arthroscopically repaired bucket-handle medial meniscal tears.Results According to Barrett criteria and MRI,64 of 87 patients repaired succeed and failure was noted in 23 patients(26.4%).The mean Lysholm,Tegner and IKDC scores improved at final follow-up in 87 patients(P<0.05).Between the groups,The mean Lysholm,Tegner and IKDC scores were also compared and the difference was significant(all P<0.05).There were no significant differences in age,gender,affected side,tear length,tear width,Competition level,Tears mechanism,mechanical locking,concurrent anterior cruciate ligament reconstruction,or smoking status between the success and failure groups(P>0.05).The results of univariate analysis and multivariate logistic regression analysis showed body mass index,time from injury to surgery and recurrent stability was associated with the unhealed rate(P<0.05).The factors such as age,BMI,time from injury to surgery,concurrent anterior cruciate ligament reconstruction and recurrent stability were further bring into the logistic regression equation.The results showed that time from injury to treatment(OR=2.100,P<0.05),BMI(OR=2.346,P<0.05)and recurrent stability(OR=1.343,P<0.05)were independent risk factors.Conclusion This study showed that repair of bucket-handle medial meniscal tears can lead to good clinical outcomes.Significant risk factors for repaired bucket-handle medial meniscal tears included time from injury to surgery(>12w),body mass index(>24kg/m~2)and recurrent stability.Consider these factors before choosing arthroscopically repaired bucket-handle medial meniscal tears.