Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: Results From the MARS Cohort.

Journal: The American Journal Of Sports Medicine

Published: August 22, 2020

Abstract

Background: Meniscal preservation has been demonstrated to contribute to long-term knee health. This has been a successful intervention in patients with isolated tears and tears associated with anterior cruciate ligament (ACL) reconstruction. However, the results of meniscal repair in the setting of revision ACL reconstruction have not been documented. Purpose: To examine the prevalence and 2-year operative success rate of meniscal repairs in the revision ACL setting. Study

Design: Case-control study; Level of evidence, 3.

Methods: All cases of revision ACL reconstruction with concomitant meniscal repair from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by phone and email to determine whether any subsequent surgery had occurred to either knee since the initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify the pathologic condition and subsequent treatment.

Results: In total, 218 patients (18%) from 1205 revision ACL reconstructions underwent concurrent meniscal repairs. There were 235 repairs performed: 153 medial, 48 lateral, and 17 medial and lateral. The majority of these repairs (n = 178; 76%) were performed with all-inside techniques. Two-year surgical follow-up was obtained on 90% (197/218) of the cohort. Overall, the meniscal repair failure rate was 8.6% (17/197) at 2 years. Of the 17 failures, 15 were medial (13 all-inside, 2 inside-out) and 2 were lateral (both all-inside). Four medial failures were treated in conjunction with a subsequent repeat revision ACL reconstruction.

Conclusion: Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up. Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.

Authors

Laura Huston, Amanda Haas, Samuel Nwosu, Christina Allen, Allen Anderson, Daniel Cooper, Thomas Deberardino, Warren Dunn, Brett Brick Lantz, Barton Mann, Kurt Spindler, Michael Stuart, Jacquelyn Pennings, John Albright, Annunziato Amendola, Jack Andrish, Christopher Annunziata, Robert Arciero, Bernard Bach, Champ Baker, Arthur Bartolozzi, Keith Baumgarten, Jeffery Bechler, Jeffrey Berg, Geoffrey Bernas, Stephen Brockmeier, Robert Brophy, Charles Bush Joseph, J Butler, John Campbell, James Carey, James Carpenter, Brian Cole, Jonathan Cooper, Charles Cox, R Creighton, Diane Dahm, Tal David, David Flanigan, Robert Frederick, Theodore Ganley, Elizabeth Garofoli, Charles Gatt, Steven Gecha, James Giffin, Sharon Hame, Jo Hannafin, Christopher Harner, Norman Harris, Keith Hechtman, Elliott Hershman, Rudolf Hoellrich, Timothy Hosea, David Johnson, Timothy Johnson, Morgan Jones, Christopher Kaeding, Ganesh Kamath, Thomas Klootwyk, Bruce Levy, C Ma, G Maiers, Robert Marx, Matthew Matava, Gregory Mathien, David Mcallister, Eric Mccarty, Robert Mccormack, Bruce Miller, Carl Nissen, Daniel O'neill, Brett Owens, Richard Parker, Mark Purnell, Arun Ramappa, Michael Rauh, Arthur Rettig, Jon Sekiya, Kevin Shea, Orrin Sherman, James Slauterbeck, Matthew Smith, Jeffrey Spang, Ltc Steven J Svoboda, Timothy Taft, Joachim Tenuta, Edwin Tingstad, Armando Vidal, Darius Viskontas, Richard White, James Williams, Michelle Wolcott, Brian Wolf, James York

Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: Results From the MARS Cohort.

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