Meniscal repair in the setting of revision anterior cruciate ligament reconstruction: 6-year follow-up results from the MARS Cohort Journal Article uri icon
Overview
abstract

  • BACKGROUND: Meniscal preservation has been demonstrated to contribute to long-term knee health and has been a successful intervention in isolation and in patients with anterior cruciate ligament reconstruction (ACLR). The long-term results of meniscal repair in the setting of revision ACLR have yet to be documented.
    PURPOSE: To report the incidence of meniscal repair failures at the 6-year follow-up in a cohort of patients who underwent concurrent revision ACLR and primary meniscal repair.
    STUDY DESIGN: Prospective cohort study; Level of evidence, 2.
    METHODS: All revision ACLRs with concomitant primary meniscal repair cases from a multicenter group between 2006 and 2011 were selected. Six-year follow-up was obtained to determine whether any subsequent surgery had occurred since their initial revision ACLR. If so, operative reports were obtained, whenever possible, to verify pathological condition and treatment.
    RESULTS: In total, 221 patients from 1234 revision ACLRs underwent concurrent primary meniscal repairs (18% of the cohort). There were 238 repairs performed: 173 medial and 65 lateral. The majority of these repairs (n = 181; 76%) were performed with an all-inside technique. Six-year surgical follow-up was obtained in 77% (171/221) of the cohort, or 189 of 238 (79%) of the repairs (136 medial, 53 lateral). The meniscal repair failure rate, defined as reoperation, was 16% (31/189) at 6 years. Of the 31 failures, 28 were medial (24 all-inside, 4 inside-out; 28/136 = 20.6% failure rate) and 3 were lateral (2 all-inside, 1 inside-out; 3/53 = 5.7% failure rate). Three medial failures were treated in conjunction with a subsequent repeat revision ACLR. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears (20.6% vs 5.7%; P = .01) and had a significantly shorter survival time compared with lateral tears (P = .02). No difference was found between the failure and nonfailure groups when it came to tear type, tear length, repair technique utilized, suture/implant type, or number of sutures used between the 2 groups.
    CONCLUSION: Meniscal repair in the revision ACLR setting has a 16% failure rate at 6 years. Failure rates for medial tears (20.6%) were found to be higher than that for lateral tears (5.7%), which aligns with previous studies in both the revision and primary ACLR setting.

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    authors
  • Fox, J. A.  
  • Huston, L. J.  
  • Haas, A. K.  
  • Pennings, J. S.  
  • Allen, C. R.  
  • Cooper, D. E.  
  • DeBerardino, T. M.  
  • Dunn, W. R.  
  • Lantz, B. B. A.  
  • Spindler, K. P.  
  • Stuart, M. J.  
  • Amendola, A. N.  
  • Annunziata, C. C.  
  • Arciero, R. A.  
  • Bach, B. R.  
  • Baker, C. L.  
  • Bartolozzi, A. R.  
  • Baumgarten, K. M.  
  • Berg, J. H.  
  • Bernas, G. A.  
  • Brockmeier, S. F.  
  • Brophy, R. H.  
  • Bush-Joseph, C. A.  
  • Brad Butler, V. J.  
  • Carey, J. L.  
  • Carpenter, J. E.  
  • Cole, B. J.  
  • Cooper, Jonathan M., MD  
  • Cox, C. L.  
  • Creighton, R. A.  
  • David, T. S.  
  • Flanigan, D. C.  
  • Frederick, R. W.  
  • Ganley, T. J.  
  • Gatt, C. J.  
  • Gecha, S. R.  
  • Giffin, J. R.  
  • Hame, S. L.  
  • Hannafin, J. A.  
  • Harner, C. D.  
  • Harris, N. L.  
  • Hechtman, K. S.  
  • Hershman, E. B.  
  • Hoellrich, R. G.  
  • Johnson, D. C.  
  • Johnson, T. S.  
  • Jones, M. H.  
  • Kaeding, C. C.  
  • Kamath, G. V.  
  • Klootwyk, T. E.  
  • Levy, B. A.  
  • Ma, C. B.  
  • Maiers, G. P.  
  • Marx, R. G.  
  • Matava, M. J.  
  • Mathien, G. M.  
  • McAllister, D. R.  
  • McCarty, E. C.  
  • McCormack, R. G.  
  • Miller, B. S.  
  • Nissen, C. W.  
  • O'Neill, D. F.  
  • Owens, B. D.  
  • Parker, R. D.  
  • Purnell, M. L.  
  • Ramappa, A. J.  
  • Rauh, M. A.  
  • Rettig, A. C.  
  • Sekiya, J. K.  
  • Shea, K. G.  
  • Sherman, O. H.  
  • Slauterbeck, J. R.  
  • Smith, M. V.  
  • Spang, J. T.  
  • Svoboda, Crsj  
  • Taft, T. N.  
  • Tenuta, J. J.  
  • Tingstad, E. M.  
  • Vidal, A. F.  
  • Viskontas, D. G.  
  • White, R. A.  
  • Williams, J. S.  
  • Wolcott, M. L.  
  • Wolf, B. R.  
  • York, J. J.  
  • Wright, R. W.  
    • publication date
  • 2025
    • published in
    Research
    keywords
  • Follow-Up studies
  • Injuries
  • Knee
  • Orthopedics
  • Prospective Studies
  • Sports
  • Surgery
    • Additional Document Info
    volume
  • 53
    • issue
  • 14