Arthroscopy - 2026-07-13 - Journal Article
Isolated Meniscus Repairs in Youth Have a 19% Complication Rate and 9% Failure Rate With Variations by Tear Type, Location, Range of Motion Protocol, and Sex at 8 Months.
Agonias K, Knell G, Pacicca D, Heyworth BE, Wilson P, Shea K, Ellis HB, Members of the SCORE Quality Improvement Registry
Topics
Key Takeaway
Isolated meniscus repair in patients ≤19 years carries a 19.2% overall complication rate and 9.2% failure rate at 8 months, with female sex, medial posterior horn/body tears, lateral oblique/parrot-beak tears, and extreme ROM protocols (locked extension or no restriction) as independent risk factors.
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Summary
This study queried the Sports Cohort Outcomes Registry (16 institutions, 26 surgeons, July 2018–January 2023) to determine early complication and failure rates for isolated meniscus repair in patients ≤19 years using the modified Clavien-Dindo-Sink classification. The overall complication rate was 19.2% (grade II 7.2%, grade III 12.0%) with a 9.2% failed repair rate. Female sex, medial posterior horn/body tears, lateral oblique/parrot-beak tears, and ROM protocols of locked extension or no restriction were each independently associated with higher complication incidence.
Key Limitation
The 8-month minimum follow-up captures early failures but misses a substantial proportion of delayed mechanical failures, meaning the 9.2% failure rate is almost certainly an underestimate of true long-term failure.
Original Abstract
PURPOSE
To evaluate the incidence of clinically significant, early postoperative complications, and associated risk factors in pediatric isolated meniscus repairs from a multicenter prospective quality improvement registry using the modified Clavien-Dindo-Sink complication classification system.
METHODS
A prospective multicenter quality improvement registry (16 institutions, 26 surgeons) designed to monitor the safety of meniscus repairs was queried between July 2018 to January 2023. Each meniscus repair among patients aged ≤19 years were included in this analysis. The minimum follow-up for this study was 8 months. The indication for surgery was made under discretion of participating Sports Cohort Outcomes Registry surgeons. The Modified Clavien-Dindo-Sink classification was used for complication identification and grading. Hospital, surgical, and patient demographics, and characteristics of the meniscus tear and repair (tear type, repair technique, and implant type) were evaluated. Bivariable tests for differences and multivariable models estimated associations between the factors of interest and complication incidence.
RESULTS
Six hundred isolated meniscus repair cases (40% women) were identified with a mean age of 15.1 years (range: 2-19). Overall complication rate was 19.2% (grade II: 7.2%; grade
III
12.0%), with a 9.2% failed repair rate. Increased incidence of postoperative complications was seen in women (P = .009), medial tears of the posterior horn and body (P = .001), lateral oblique/parrot beak tears (P = .001), and range of motion protocol of locked in extension and no restriction (P = .03).
CONCLUSIONS
This study identified that postoperative complications in isolated meniscal repair occur in nearly 1 in 5 patients, and failed repair occurs in nearly 1 out of 11 patients. This study revealed failure rates consistent with previous adult and pediatric studies. Complication incidence more frequently occurred in medial tears of the posterior horn and body, and posterior roots; lateral complex and oblique/parrot-beak tears, range of motion protocol of locked in extension and no restriction, and female patients when compared with male patients.
LEVEL OF EVIDENCE
Level III, retrospective case series.