Arrows Hit the Mark for Knee RepairIf you tear your meniscus, or knee cartilage, current practice suggests fixing the tear rather than removing the damaged cartilage. Meniscal repair preserves the knee and prevents more problems down the line. But how do surgeons repair tears of this kind?
In the last decade, new devices have replaced simple sutures in knee surgery. One of these is the meniscus arrow. Shaped like an arrow, this device has barbs to hold torn cartilage in place. The meniscus arrow is bioabsorbable and dissolves in the body over time. Even better, the arrow can be inserted using an arthroscope. This tool lets surgeons work under the skin without making big incisions. This reduces surgery and healing time.
A number of studies show that meniscus arrows are strong and effective. This study echoes those results. Thirty patients had meniscal repairs using two or more arrows. Most of the patients also had anterior cruciate ligament (ACL) repairs at the same time to stabilize the knee.
About two years later, 83 percent of the patients had good or excellent results, no matter what the size of the tear. In two cases the surgery was said to have failed. These patients went on to have more surgery.
There were no major complications from surgery. A few patients had skin irritation from the arrow tips. These symptoms went away with injections or on their own. Skin irritation may be avoided by choosing arrows of the right length, so that the tips do not stick out.
The authors feel that meniscus arrows are safe and effective for meniscal tears. Meniscus arrows must be inserted properly, so that the barbs are engaged. The authors recommend bracing and four weeks of no weight-bearing activity after surgery. More movement and weight bearing may be okay, but more research is needed to say for sure. Finally, ACL damage must be addressed to get the best results from meniscal repair. If the knee is unstable, it is only a matter of time before the meniscus repair fails.
Timothy S. Petsche, MD, et al. Arthroscopic Meniscus Repair With Bioabsorbable Arrows. In Arthroscopy. March 2002. Vol. 18. No. 3. Pp. 246-253.
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