2023 ISAKOS Biennial Congress ePoster
Biological Augmentation May Play A Role In Obtaining Superior Clinical Outcomes In Meniscal Root Repair With Concomitant Anterior Cruciate Ligament Reconstruction
Lika Dzidzishvili, MD, PhD, Barcelona SPAIN
Irene Isabel López-Torres, MD, PhD, Madrid SPAIN
David Sáez, MD, Madrid SPAIN
Antonio Hernández Diez, MD, Madrid SPAIN
Emilio Calvo, MD, PhD, MBA, Madrid SPAIN
Hospital Universitario Fundación Jiménez Díaz, Madrid, SPAIN
FDA Status Not Applicable
Summary
Biological augmentation may play a role in obtaining superior clinical outcomes in meniscal root repair with concomitant anterior cruciate ligament reconstruction
ePosters will be available shortly before Congress
Abstract
Background
Meniscal repair (other than root repair) in the setting of anterior cruciate ligament (ACL) reconstruction has demonstrated superior outcomes compared with isolated meniscal repair. It has been theorized that the reason behind these improved outcomes relates to a favorable healing environment created by biological augmentation of the repair from the intra-articular release of the bone marrow when drilling the ACL tunnels. Limited evidence exists for the effects of biological augmentation on isolated meniscal root repair, particularly when compared with meniscal root with concomitant ACL reconstruction.
The main purpose of the study was to compare the outcomes of meniscal root repair in 2 cohorts of patients: isolated meniscal root repair and meniscal root repair with concomitant ACL reconstruction.
Methods
A comparative case-control analysis was conducted. Thirty-four patients were included in two therapeutic group: 17 patients who underwent concomitant meniscal root repair and ACL reconstruction (ACLR) were matched with 17 patients with isolated root repair (RR). Primary clinical outcomes at a minimum of 29.4 (SD ± 5.5) months postoperatively included Knee injury and Osteoarthritis Outcome Score (KOOS) and Lysholm Knee Questionnare (LKQ). Radiographic assessment of the knee was performed to determine osteoarthritis severity using the Kellgren-Lawrence (KL) grading system. In addition, pre and postoperative MRI scans and intraoperative arthroscopic findings were documented. Differences in outcome scores, survivorship, and failure rates between the cohorts were assessed. Failure was defined as reoperation with meniscectomy or revision meniscal repair.
Results
Patients in the ACLR group exhibited significantly greater improvement in clinical outcomes in both, the overall KOOS4 and LKQ scores (p=0.029, 0.039, respectively). No significant difference in radiological progression of arthritic changes was observed postoperatively between the groups using KL score (p=1.000). None of the patients referred postoperative knee instability during daily activities and no re-tears were observed in either group at final follow-up.
Regarding postoperative MRI findings, no significant difference in postoperative meniscal extrusion, chondropatia patella, and osteochondral defect were recorded between the cohorts (p =0.118, 0.688, and 1.000, respectively).
Conclusions
The superior clinical outcomes reported for meniscal root repair with ACL reconstruction may be partly attributed to biological augmentation during ACL tunnel drilling.