Arthroscopic Sutures of the External and Internal Meniscus at Ordre De Malte Hospital in Dakar: The Case of 13 Patients

Authors: Kinkpe CVA*, Niane MM, Bonkian G, Gueye AB, Daffe M, Porgo A, Traore MM and Kesenge J

DOI: 10.23880/jobd-16000144

Volume 1, Issue 8

Abstract

Introduction: The management of traumatic lesions of the menisci is an up to date topic. The treatment has for long remained mutilating and the evolution towards osteoarthritis inevitable. In the light of the original work, important progress has been noted, which now allows conservative arthroscopic treatment in about 20% of cases. The scarcity of data in the West African literature on this topic and the need for a retrospective look at such a treatment which has been practiced at Ordre de Malte Hospital since 2012, motivate this study. Material and Method: This is a retrospective study from 2012 to 2015. A series of 13 meniscal sutures or 10.5% of 124 lesions explored and treated arthroscopically. This exclusive male series whose mean age is 28 years (20 - 49) was followed with a average follow-up of 38 months (23 - 62).
Results: The average consultation time was 2 years and for 11 times (85%) the lesion had occurred following an accident during sport, of a contact + / pivot type . The lesions being found 11 times on the right, 9 times on the medial meniscus, 10 times on the posterior segment, and 9 times on the average segment. It was a bucket handle in 9 cases including 4 dislocated cases. The suture was performed "from outside to inside" and was made stable with an average of 2 points with Prolene 2/0. In 3 cases, this suture was associated with ACL DIDT Ligamentoplasty. We noted as complications: a case of intraoperative failure that led to partial regulation, an early superficial infection of the operative site and a thromboembolic event that had evolved well under treatment. At the last follow-up, 11 patients were satisfied or very satisfied compared to 2 disappointed. The average Lysholm score was 94.7 / 100 with 12 good or excellent results; the IKS score was 100% in all patients and the average knee IKS was 95.6 / 100. IKDC clinical evaluation of 10 patients seen at last follow-up reported 07 patients ranked "A" and 03 ranked "B". Anatomically, the MRI and the Arthro-CT found evidence of partial scarring. 9 patients resumed sport, and 4 of them claimed to have achieved their previous performance.
Conclusion: The functional results encourage the continuation of this activity with equipment enabling internal reparations.

Keywords:

Meniscal Suture; Bucket Handle; Arthroscopy; Outside to Inside

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