Purpose: To report the functional and radiologic outcomes of meniscal repair healing in a cohort of patients with a high demand for loaded extreme flexion angles after undergoing meniscal repair. Methods: We performed a retrospective clinical and radiologic evaluation of patients who perform extreme knee flexion activities on a daily basis at a minimum follow-up of 2 years after meniscal repair. International Knee Documentation Committee, Lysholm, and Tegner scores were obtained, and clinical examinations and radiologic (magnetic resonance imaging and radiography) evaluations were performed. Results: Of 47 eligible patients, 39 patients (40 knees) were available for review with an average follow-up time of 5 years (range, 2-9 years). The average age was 26.7 years (range, 19-39 years); 38 patients were men. The average time from injury to surgery was 20.9 months (range, 3 days to 120 months). Associated anterior cruciate ligament injury was present in 31 knees, but only 20 underwent simultaneous anterior cruciate ligament surgery. The mean International Knee Documentation Committee score was 88.9 (range, 53-99). The mean Lysholm score was 90.9 (range, 48-100). The mean Tegner activity level dropped from 6.18 before injury to 5.51 at the time of evaluation. According to the Barrett criteria for clinical outcomes, complete healing was observed in 29 of 40 knees (72.5%). There was a statistically significant correlation between the functional outcomes and the clinical outcomes (P = .008). On magnetic resonance imaging, 22 of 38 knees (57.9%) showed completely healed menisci. Conclusions: The results of this study suggest that loaded deep knee flexion may be safe after a period of restricted rehabilitation, and clinical and radiologic tissue healing is independent of the overall functional outcome. Level of Evidence: Level IV, case series with subgroup analysis.
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