Podium Presentation Meniscus

23.1.2 - Does Repair of Horizontal Cleavage Meniscus Tears Improve Patient Outcomes? 1 Year Results from Prospective Multi-Center STITCH Trial

Presentation Number
23.1.2
Presentation Topic
Meniscus
Lecture Time
10:39 - 10:48
Session Type
Free Papers
Corresponding Author
  • D. Flanigan (Columbus, US)
Authors
  • D. Flanigan (Columbus, US)
  • A. Krych (Rochester, US)
  • A. Anz (Gulf Breeze, US)
  • F. Gwathmey (Charlottesville, US)
  • J. Larson (Columbus, US)
  • G. Loren (Winchester, US)
  • M. Lavery (Greenwood, US)
  • L. Jazrawi (New York, US)
  • S. Faucett (Washington, US)
  • L. McIntyre (Sleepy Hollow, US)
  • P. Kurzweil (Long Beach, US)
Disclosure
This multi center study was supported by Ceterix that is now owned by Smith & Nephew Aesculap DF, AK Allosource SF Anika Orthopedics DF Arthrex LJ, AA, AK CartiHeal DF Ceterix DF, SF, JL, FG, AK, PK, LM Conmed MTF DF Depuy

Abstract

Purpose

The study objective was to evaluate 1 year outcomes of Horizontal Cleavage Tear (HCT) repairs including reoperation and patient-reported outcomes (PROs).

Methods and Materials

A Prospective, Non-randomized, Multi-Center Investigation of All Suture-based Repair of Horizontal Meniscal Tears (STITCH) enrolled patients, ages 18-60, with HCTs repaired using circumferential sutures placed with a self-retrieving all-inside suture repair device with or without adjunct all-suture techniques. Patients with grade ≥3 OA, BMI ≥35kg/m2, prior meniscus surgery, instability, malalignment, or tobacco abuse were excluded.

Results

30 patients were enrolled, with the majority male (68%) and an average age of 38.1±11.7years. Tears were predominantly in the medial compartment (68%), extended into Zone 2 or 3 (64%), with an average length of 18.3±5.8mm and an average of 4.9±2.7stitches placed.Three subjects were disqualified for anchor usage, one lost to follow-up, and one dropped out, and one exited due to infection. At the time of this abstract, three patients had not returned for the 1 year visit. Of the remaining 21 patients, two (9.5%) required reoperation of the original meniscus tear. There was significant improvement on all scales measured: IKDC (40.4±20.5, p<0.001), KOOS Pain (31.8±19.0, p<0.001), KOOS Sport (41.9±28.7, p=0.001), KOOS Symptom (29.5±21.6, p<0.001), KOOS ADL (30.3±15.0, p<0.001), KOOS QOL (41.5±27.7, p<0.001), Tegner (1.9±2.7, p=0.003), Lysholm (29.6±24.0, p=0.001). 16/19 (84.2%) and 15/19 (78.9%) of patients met the minimal clinically important difference (MCID) for improvement in IKDC and Lysholm scores, respectively. Age, BMI, length of tear, and tear location were not independent predictors of success, although the study may not be sufficiently powered.

Conclusion

1 year results demonstrate improvement in clinical outcomes and low reoperation rates for patients with circumferential meniscus repair of HCTs. Subjects will be followed for 2 years to assess durability of results.

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