Recurrent Meniscal Instability Requiring Revision Repair 28 Years After the Initial Repair for a Bucket Handle Medial Meniscus Tear: A Case Report

In recent decades, arthroscopic meniscal repair has been increasingly indicated for meniscal tears in the last decades. Although literature generally reports favorable surgical outcomes, it remains unclear whether the repaired meniscus maintains its function over the long term while performing its chondroprotective function without recurrent tear after clinical healing. A 43-year-old Japanese man who underwent meniscal repair for a bucket handle tear of the medial meniscus (MM) at the age of 15 years presented with right knee pain and catching symptoms without a preceding traumatic event. Physical examination revealed joint line tenderness and a catching sensation with rotating motion in the medial aspect of the knee. Plain radiographs showed no apparent osteoarthritic changes. Magnetic resonance imaging (MRI) showed infiltration of joint fluid at the interface between the MM and the joint capsule. Based on the patient's history and the examination results, a retear of the MM was diagnosed, and revision MM repair was conducted using the inside-out technique. At the 2-year follow-up, the patient remained asymptomatic, physical examination revealed no meniscal symptoms, and radiological examination showed no signs of osteoarthritic progression. The present study details a case involving a retear of a repaired meniscus without an inciting traumatic event after a 28-year asymptomatic period is reported. The long-term results of meniscus repair surgery performed more than 20 years ago have rarely been reported in the literature. This case report indicates that the long-term preservation of articular cartilage following successful meniscal repair can be attributed to the maintenance of meniscal function. On the other hand, even after clinical healing has been achieved, there is a possibility that the risk of meniscal retear will continue over time.