• Vladimir Senekovič Klinični oddelek za travmatologijo Kirurška klinika Klinični center Zaloška 2 1525 Ljubljana
  • Katja Štrus Klinični oddelek za travmatologijo Kirurška klinika Klinični center Zaloška 2 1525 Ljubljana
  • Matija Krkovič Klinični oddelek za travmatologijo Kirurška klinika Klinični center Zaloška 2 1525 Ljubljana
Keywords: meniscus, tear, arthroscopy, bioabsorbable arrows, local anesthesia


Background. The menisci have important function in the knee joint. Because of this it is universally accepted that we have to preserve them as much as possible. After open and partially arthroscopic suture techniques new methods of all-inside meniscus repair with bioabsorbable arrows have been developed in the last decade. The meniscus repair using these arrows represents an easy task for a skilled surgeon. In addition, it can be performed in local anesthesia. We have evaluated the results of the first group of patients who were treated by this method.

Methods. From February 2001 to August 2002 15 patients with torn meniscuses have been treated at the Clinical Department for Traumatology, University Medical centre, Ljubljana. We repaired their torn menisci arthroscopically with bioabsorbable arrows in local anesthesia. We divided patients in three groups: a group with isolated meniscus injury, a group with meniscus injury and anterior cruciate ligament injury and a group with associated pathology. Four patients had incarcerated meniscuses. Preoperative Lysholm score in the first group was 38, in the second 42 and in the third group 48. We repaired 12 medial and 3 lateral meniscuses. On average we need 45 minutes for therapeutic arthroscopy. Torn meniscus was fixated with minimum of 1 and maximum of 5 bioabsorbable arrows. All patients except one had the affected knee immobilized with cylinder plaster for 15 days on average.

Results. At least three months after the arthroscopic fixation of the torn meniscus in local anesthesia another clinical evaluation was made. In all groups significant improvement was observed regarding the range of motions and absence of pain. Postoperative Lysholm score in the first group was 89, in the second 75 and in the third 71. Average deficit of flexion was 3 degrees while extension was full. One patient complained about the same pain in the joint, he underwent another arthroscopy which showed that the meniscus was not healed. The second one had another injury. We partially removed meniscus at second operation in both cases. Two patients from the group with ACL injury underwent second operation because of ACL reconstruction. The meniscuses were stabile to palpation in both cases. We observed complications of the unspecific type only in one patient who had repetitive effusions.

Conclusions. We can confirm that the meniscus repair with bioabsorbable arrows is technically easy and fast procedure. It can be performed with good results in local anesthesia.


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Walker P, Erkman MJ. The role of the menisci in force transmission acros the knee. Clin Orthop 1975; 109: 185–90.

Fairbanks TJ. Knee joint changes after meniscectomy. J Bone Surg Br 1948; 4: 664–70.

Cabaud HE, Rodkey WG, Fitzwater JE. Medial meniscus repair – an experimental and morphologic study. Am J Sports Med 1981; 9: 129–34.

Jakob RP, Stäubli HU, Zuber K, Esser M. The arthroscopic meniscal repair. Techniques and clinical experience. Am J Sports Med 1988; 16: 137–42.

Warren FW. Arthroscopic meniscus repair. Arthroscopy 1985; 1: 170–2.

Small NC. Complications in arthroscopic meniscal surgery. Clin Sports Med 1990; 9: 609–17.

Albrecht-Olsen P, Kristensen G, Tormala P. Meniscus bucket handle fixation with an absorbable Biofix tack: Development of a new technique. Knee Surg Sports Traumatol Arthosc 1993; 1: 104–6.

Veselko M, Senekovič V, Tonin M. Ambulantni artroskopski posegi v lokalni anesteziji – analiza 142 posegov. Zdrav Vestn 1995; 64: 141–3.

Albrecht-Olsen P, Kristensen G, Burgaard P, Joergensen U, Toerholm C. The arrow versus horizontal suture in arthroscopic meniscus repair; a prospective randomized study with arthroscopic evaluation. Knee Surg Sports Traumatol Arthrosc 1999; 7: 268–73.

Lysholm J, Tegner Y, Gillquist J. Functional importance of different clinical findingstable knee. Acta Orthop Scand 1984; 55: 472–2.

Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop 1985; 198: 43–9.

Petsche TS, Selesnick H, Rochman A. Arthroscopic meniscus repair with bioabsorbable arrows. Arthroscopy 2002; 18: 246–53.

Laprell H, Stein V, Petersen W. Arthroscopic all-inside meniscus repair using a new refixation device: A prospective study. Arthroscopy 2002; 18: 387–93.

Ganko A, Engebretsen L. Subcutaneus migration of meniscal arrows after failed meniscus repair: a report of two cases. Am J Sports Med 2000; 28: 252– 4.

Anderson K, Marx RG, Hannafin J, Warren RF. Chondral injury following meniscal repair with a biodegradable implant. Arthroscopy 2000; 16: 749– 53.

Seil R, Rupp S, Dienst M, Mueller B, Bonkhoff H, Kohn DM. Chondral lesions after arthroscopic meniscus repair using meniscus arrows. Arthroscopy 2000; 16: E 17.

Ross G, Grabill J, McDevitt E. Chondral injury after meniscal repair with bioabsorbable arrows. Arthroscopy 2000; 16: 754–6.

Oliverson TJ, Lintner DM. Biofix arrow appearing as subcutaneus foreign body. Arthroscopy 2000; 16: 652–5.

Hechtmann KS, Uribe JW. Cystic hemathoma formation following use of a biodegradable arrow for meniscus repair. Arthroscopy 1999; 15: 207–10.

Song EK, Lee KB, Yoon TR. Aseptic synovitis after meniscal repair using the biodegradable meniscus arrow. Arthroscopy 2001; 17: 77–80.

De Haven KE, Lohrer WA, Lovelock JE. Long-term results of open meniscus repair. Am J Sports Med 1995; 23: 524–30.

Rosenberg TD, Scott SM, Coward DB. Arthroscopic menisceal repair evaluated with repeatarthroscopy. Arthroscopy 1986; 2: 14–20.

Cannon WD, Vittori JM. The incidence of healing in arthroscopic meniscus repairs in cruciate ligament-reconstructed knees versus stable knees. Am J Sports Med 1992; 20: 176–81.

Barber FA. Accelerated rehabilitation for meniscus repairs. Arthroscopy 1994; 10: 206–10.

Barber FA, Click SD. Meniscus repair rehabilitation with concurrent anterior cruciate reconstruction. Arthroscopy 1997; 13: 433–7.

Shelbourne KD, Patel DV, Adsit WS, Porter DA. Rehabilitation after meniscal repair. Clin Sports Med 1996; 15: 595–612.

How to Cite
Senekovič V, Štrus K, Krkovič M. ARTHROSCOPIC MENISCUS REPAIR WITH BIOABSORBABLE ARROWS IN LOCAL ANESTHESIA. ZdravVestn [Internet]. 1 [cited 22Sep.2019];73(11). Available from:
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