The Biofix absorbable Meniscal Arrow (BIONX Implants, Ltd., Tampere, Finland) has become an acceptable alternative to meniscal suture because of its ease of use and lower risk of neural and vascular complications.' The arrow is a T-shaped fastener with a barbed shaft and a sharply pointed apex. It is available in 10-, 13-, and 16-mm lengths, recommended for the anterior, middle, and posterior thirds of the meniscus, respectively. This polylactic acid arrow remains structurally intact for approximately 6 months and takes up to 3 years to fully resorb. There has been a recent report of four cases of transient posterior knee pain with the Meniscal Arrow.(5) We report on two patients with more significant symptoms that did not resolve spontaneously but necessitated removal of the arrows. Since the beginning of 1997, we have used the Biofix Meniscal Arrow system at our institution in 38 cases. A total of 114 arrows were inserted in these 38 patients. All of these cases were bucket-handle tears of the medial and lateral menisci. The patient selection for this procedure has been conservative, with only peripheral red-on-red or red-on-white tears in young patients being treated. In euo instances, patients developed nontransient knee pain related to the Meniscal Arrows. In both cases the meniscus repair failed. Failure of meniscus repair is not uncommon.(5) One study reported failure in greater than 20% of cases (4 of 19) in which the Meniscal Arrow was used.(4)
