Vascular Zone Matters: Clinical Outcomes of Arthroscopic Meniscal Repair in Red–Red, Red–White, and White–White Tears

Abstract

Objective: Meniscal repair is superior to meniscectomy in preserving knee biomechanics and preventing degenerative progression. However, the healing potential may differ depending on the vascular zone. This study aimed to compare the clinical and functional outcomes of meniscal tears located in distinct vascular regions. Materials and Methods: A retrospective review was conducted on 118 patients who underwent arthroscopic meniscal repair between 2015 and 2025, with a minimum 12-month follow-up. Tears were categorized as red–red (RR, n=42), red–white (RW, n=53), or white–white (WW, n=23). Outcomes were assessed using IKDC, Lysholm, and VAS scores. Return-to-sport time, patient satisfaction, and complication rates were also analyzed. Group comparisons and multivariate logistic regression were performed to determine independent predictors of failure. Results: At the 12-month follow-up, functional scores were significantly higher in the RR group (IKDC 89.3; Lysholm 91.7) and VAS scores were lower (1.8) than in other groups (p<0.001). The mean return-to-sport time was shorter in RR tears (5.8 months) than in RW (6.4) and WW (8.2) groups (p<0.001). Satisfaction was highest in RR (90.5%) and lowest in WW (60.9%) tears (p=0.004). Complications were least frequent in RR (14.3%) and most common in WW (39.1%; p=0.03). WW localization independently predicted repair failure (OR=4.98; 95% CI: 1.88–13.18; p=0.001). Conclusion: Meniscal repair outcomes vary according to vascular zone. RR-zone tears achieve better function, faster recovery, and fewer complications, whereas WW-zone tears have a higher risk of reoperation. Vascular zone evaluation should guide surgical decision-making.

Keywords

• Complication
• functional outcome
• knee arthroscopy
• meniscus repair
• vascular zone

Vasküler Zon Önemlidir: Kırmızı–Kırmızı, Kırmızı–Beyaz ve Beyaz–Beyaz Yırtıklarda Artroskopik Menisküs Onarımının Klinik Sonuçları

Abstract

Giriş: Menisküs onarımı, diz biyomekaniğinin korunması ve dejeneratif süreçlerin önlenmesinin sağlanması açısından menisektomiye göre daha üstün kabul edilmektedir. Ancak onarım başarısı, menisküsün bulunduğu vasküler zonun kanlanma düzeyine bağlı olarak değişiklik gösterebilmektedir. Bu çalışma, farklı vasküler bölgelerdeki menisküs yırtıklarında klinik ve fonksiyonel sonuçları karşılaştırmayı amaçlamıştır. Materyal ve Metot: 2015–2025 yılları arasında artroskopik menisküs onarımı uygulanan ve en az 12 ay takip edilen 118 hasta retrospektif olarak incelendi. Yırtıklar kırmızı–kırmızı (RR, n=42), kırmızı–beyaz (RW, n=53) ve beyaz–beyaz (WW, n=23) zon olarak sınıflandırıldı. Fonksiyonel sonuçlar IKDC, Lysholm ve VAS skorlarıyla değerlendirildi; spora dönüş süresi, hasta memnuniyeti ve komplikasyon oranları kaydedildi. Gruplar arası farklar uygun istatistiksel testlerle analiz edildi ve onarım başarısızlığını öngören bağımsız değişkenler çok değişkenli lojistik regresyon analizinde belirlendi. Bulgular: On ikinci ayda RR grubunda fonksiyonel skorlar anlamlı olarak daha yüksekti (IKDC: 89,3; Lysholm: 91,7) ve ağrı skorları daha düşüktü (VAS: 1,8) (p<0,001). Spora dönüş süresi RR grubunda (5,8 ay), RW (6,4 ay) ve WW (8,2 ay) gruplarına kıyasla daha kısaydı (p<0,001). Hasta memnuniyeti RR grubunda en yüksek (%90,5), WW grubunda en düşüktü (%60,9) (p=0,004). Komplikasyon oranı RR grubunda %14,3, WW grubunda %39,1 olarak saptandı (p=0,03). Lojistik regresyon analizinde WW lokalizasyonu onarım başarısızlığının bağımsız bir öngördürücüsü olarak belirlendi (OR=4,98; %95 GA: 1,88–13,18; p=0,001). Sonuç: Menisküs onarımının başarısı, yırtığın bulunduğu vasküler zonla yakından ilişkilidir. RR zonundaki yırtıklar daha iyi fonksiyonel iyileşme, daha hızlı spora dönüş ve daha düşük komplikasyon oranları göstermektedir. Buna karşılık WW zonundaki yırtıklar daha yüksek başarısızlık riski taşımaktadır.

Keywords

• Diz artroskopisi
• fonksiyonel sonuç
• komplikasyon
• menisküs onarımı
• vasküler zon

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