A “watch” has been issued regarding potential risks with anchor-based all-inside meniscal repairs, according to a news release from The Journal of Bone and Joint Surgery.
The “watch,” issued by JBLS Case Connector—an online case report journal published by The Journal of Bone and Joint Surgery—also offers tips for successfully using FAST-FIX meniscal-repair devices produced by London-based Smith & Nephew.
All-inside meniscal repair has many potential advantages, such as shorter surgical time and reduced risk of neurovascular tissues. However, potential issues with the procedure include risk of soft-tissue irritation and implant migration or breakage, per the release.
In particular, the release explains, the “Watch” is based on a July 22, 2015 JBJS Case Connector report by Rauck et al, presenting two cases in which FAST-FIX anchors came loose postoperatively, causing knee pain within 2 to 6 months after anchor placement.
In the first case, a meniscal anchor came undone and lodged near the anterior horn of the medial meniscus, while in the second case, an implant became lodged underneath the anterior horn of the lateral meniscus.
Continues the release, while the “watch” recognizes the benefits of the procedure and the general success with the FAST-FIX repair device, it notes that the cases discussed indicate the need to consider the possibility of loose anchors in patients who experience pain and mechanical symptoms following the procedure.
Perhaps the most important key to success is to use FAST-FIX in areas of the meniscus that provide strong holding tissue, the release states.
According to Tim Spalding, FRCS, an experienced FAST-FIX user at the University Hospital in Coventry, England, in the release, the best grip site for anchors is the posterior third of the medial meniscus. On the other hand, the biggest grip-hold challenge is tears of the lateral meniscus near the popliteal hiatus.
“The publication of ‘Watches’ helps fulfill our mission to serve the orthopaedic community,” comments Marc Swiontkowski, MD, editor of JBJS Case Connector, in the release.
“The ‘Watch’ designation may encourage the orthopedic community to either demonstrate that these are isolated, unrelated cases or sharpen the focus further by rigorously evaluating the intervention and/or reporting related cases,” he continues.
[Source(s): The Journal of Bone and Joint Surgery, Science Daily]