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Functional Outcomes of Arthroscopic Combined Anterior Cruciate Ligament Reconstruction and Meniscal Repair: A Retrospective Analysis

Shirish Pathak, M.S., Abhinav Bharadwaj, M.S., Prateek Patil, M.S. and 2 more

Arthroscopy, Sports Medicine, and Rehabilitation · 2020

doi:10.1016/j.asmr.2019.11.001 (opens in a new tab)

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Abstract

Purpose To evaluate the outcomes of arthroscopic meniscal repair performed in combination with anterior cruciate ligament (ACL) repair. Methods This study presents a case series of 34 patients who underwent repair of meniscal tears along with ACL reconstruction from 2014 to 2016. Cases of discoid meniscal lesions and combined or ligament injuries other than ACL injuries were excluded. Patients were followed up periodically, at 3, 6, 9, 12, and 24 months. Preoperative and postoperative functional evaluations were performed using visual analog scale, International Knee Documentation Committee, and Lysholm knee scores. Results The mean age of the patients was 29.1 years (range, 17‐44 years). The mean follow‐up period was 18 ± 7.8 months (range, 6‐24 months). Among the 34 individual knees, 1 patient (3%) underwent both medial and lateral meniscal repairs. Medial meniscal repair was performed in 20 knees (59%), whereas the lateral meniscus was repaired in 13 knees (38%). A longitudinal tear was the most common type of tear pattern, followed by radial (6 patients) and complex (3 patients) tear patterns. The radial and complex tears were treated with an additional partial meniscectomy. The mean International Knee Documentation Committee score was 38.46 preoperatively and improved to 80.30 at final postoperative follow‐up (statistically significant difference, P < .01). The mean Lysholm score was 50.30 preoperatively and improved to 91.40 at final postoperative follow‐up (statistically significant difference, P < .01). According to the Lysholm knee score, 31 patients (89%) had excellent or good results. The mean visual analog scale score decreased from 7.3 preoperatively to 2 postoperatively. The clinical success rate of the repairs was 89%. Of 35 repairs, 4 (11%) had retears. Conclusions Arthroscopic meniscal repair along with ACL reconstruction provided predictable high rates of meniscal healing and yielded favorable functional and clinical results. Patient selection remains one of the most important prognostic factors. Level of Evidence Level IV, therapeutic case series.

Abstract licence: CC BY-NC-ND

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