Arthroscopic revisions in failed meniscal surgery

The aim of this study was to classify meniscal tear forms as found in 195 revision arthroscopies. Interval between primary arthroscopy and revision was 7.8+/-5.6 month. All patients were available for control after 1 year. In 174 knees the lesion was located in the medial meniscus and in 21 knees in the lateral meniscus. In the medial meniscus an unstable posterior meniscal horn was seen in 93 knees followed by incomplete horizontal tear and meniscal destruction in 37. Flap tear, circumferential tear, and failed meniscal repair were also seen. In the lateral meniscus destruction of a discoid meniscus, instability near the popliteal hiatus, and various tear forms were seen with nearly equal frequency. Postoperatively Lysholm score increased significantly in both groups. Most meniscal tears, found in revision arthroscopy, are caused by an insufficient primary operation. A diligent analysis of the tear form is absolutely necessary. An adequate radical resection technique to establish a smooth meniscal crest is indispensable.