Meniscal repair with biofix arrows - Results after 4.7 years' follow-up

Background: Absorbable meniscus arrows have, since they were introduced in 1993, become a common all-inside technique in meniscal repair. Potential advantages are conserving the meniscus, simplifying the surgical technique, reducing operating time, and reducing the risk of neurovascular damage. Despite extensive use all over the world, few long-term follow-up studies have been published. Hypothesis: Meniscus arrows have, based on published material, a rate of success around 80% to 90%. Study Design: Case series; Level of evidence, 4. Methods: The Biofix arrow fixation technique was used in 123 patients in need of meniscal repair from January 1997 to December 2002 at our hospital. The patients underwent an interview by phone, mail, or e-mail during autumn 2004 that included questions about reoperation and Lysholm score. In addition, the operative charts were reviewed. Results: There were 118 patients (96%) available for the questionnaire, and 45 of these (38%) had had reoperations done because of meniscal rerupture during the follow-up period. Another 3 patients were waiting for meniscal reoperations. In addition, the charts of 2 of those unavailable for the study showed that they had been reoperated, resulting in a total of 41 % verified failures. The Lysholm score for the whole study group at follow-up was 85 (range, 36-100). The mean Lysholm score for those who had a second operation was 81 (range, 36-100), and it was 88 (range, 55-100) for the others (P = .009). The mean time between primary operation and reoperation was 17 months (range, 1-75 months). Mean postoperative follow-up was 4.7 years (range, 1.8-7.7 years). Conclusion: Meniscal repair with Biofix arrows has an unacceptably low rate of success.