Meniscal Repair: Intra- and Postoperative Complications. In Surgery of the Meniscus. (Book Chapter)

All meniscal repairs have become increasingly popular and have tended to convert meniscal suturing into a standard procedure. The most classical complications are neurovascular damage in relation to the minimal invasive approach for arthroscopic posteromedial and posterolateral portals as well as insertions of implants without direct visualization of the neurovascular structures. With the evolution of meniscal devices and implants, new complications in meniscal repair surgery have emerged, especially with first-generation implants (arrow, dart, staples, and screws). Repair techniques have also been developed. Over the years, many reports on specific complications relating to all-interior devices have been published. Chondral injuries, implant loosening, device migration, capsular or neural irritations, foreign body reactions, and cystic granulomas have all been described in the literature following the use of meniscal fixation devices. Since hybrid meniscal devices allow for easier meniscal sutures with lower risk of neurovascular injury, more appropriate suture placement, and the easy handling of the instruments, information delivered to patients regarding potential complications should take into account the rarefaction of complications reported in the literature.
In many ways, all-inside devices are an interesting alternative to conventional suture techniques. However, precise knowledge of their potential complications and the pitfalls during surgery is crucial in doing a risk evaluation in order to make the correct choice of technique, suited to the individual patient, and to successfully achieve meniscal reconstruction. Although many clinical investigations report excellent results with a healing rate of around 80 %, potential complication of such a procedure must still remain a focus to maximize our surgical performances.