Arthroscopic all-inside repair using the meniscus arrow: Long-term clinical follow-up of 113 patients

Purpose: A clinical trial was carried out to investigate the long-term outcome of Meniscus Arrow (Bionx Implants, Blue Bell, PA) repair. Methods: In a case series 113 consecutive patients with an arthroscopic all-inside Meniscus Arrow repair were evaluated. The mean age was 30 years, and the mean length of follow-up was 6 years. Of the patients, 84% were available for follow-up. Repairs were performed in either the medial (81%) or lateral (19%) posterior horn in only the red-red or red-white meniscal zone. Concomitant anterior cruciate ligament reconstruction was performed in 66% of patients. Results: Of the patients, 28% showed a retear of the meniscus and had to undergo arthroscopic revision with partial meniscectomy. Simultaneous anterior cruciate ligament reconstruction had no significant influence on the revision rate. In patients who did not undergo revision, the mean Lysholm score was 91 points and the mean Cincinnati knee score was 93 points. The International Knee Documentation Committee classification was A or B in 90% of patients and C in 10%. At revision surgery, 2 patients showed distinct femoral cartilage damage caused by the head of the Meniscus Arrow. Conclusions: The Meniscus Arrow shows a high clinical failure rate of 28.4%, especially given that the use of the device was restricted to tears in the red-red and red-white zone of the meniscus, which would be expected to have a good heating potential. More than 80% of all failures occurred during the first 3 postoperative years, suggesting that the initial refixation potential of the Meniscus Arrow is low. Device-specific complications required additional operative treatment. Level of Evidence: Level IV, therapeutic case series.