ISAKOS: 2023 Congress in Boston, MA USA

2023 ISAKOS Biennial Congress ePoster

 

Predictors of Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction With Concurrent Treatment of Bucket-Handle Meniscus Tears

Gregory Perraut, MD UNITED STATES
Rachel E Cherelstein, BS, Arlington, VA UNITED STATES
Alexandra Galel, MD, West Hartford, CT UNITED STATES
Laura Keeling, MD, Washington, DC UNITED STATES
Christopher M Kuenze, PhD, Charlottesville, VA UNITED STATES
Andrew Curley, MD, Chicago, IL UNITED STATES
David X. Wang, MD, Pittsburgh, PA UNITED STATES
Kaitlin A Malekzadeh, , Great Falls, VA UNITED STATES
Edward S. Chang, MD, Washington, DC UNITED STATES

INOVA Health System, Falls Church, VA, UNITED STATES

FDA Status Not Applicable

Summary

This study is an examination of the demographic and surgical factors that influence patient-reported knee function in patients who undergo ACL reconstruction with concurrent bucket handle meniscus tear procedure.

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Abstract

Background

Bucket handle meniscus tears (BHMTs) represent 10% to 26% of all meniscus tears and often present concurrently with anterior cruciate ligament (ACL) tears; one study identified BHMTs in 13.4% of acute ACL tears and 32.3% of chronic ACL tears. However, patient-reported outcomes have been infrequently studied in this patient population.

Purpose

To examine demographic and surgical factors that influence patient-reported knee function in patients who undergo ACL reconstruction (ACLR) with concurrent BHMT procedure.

Methods

41 patients with BHMT at the time of ACLR completed the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) via online survey at an average of 15.2 months post-op. Patient demographics and surgical characteristics were compared between repair and meniscectomy groups using one-way ANOVAs; distributions of sex, graft source, BHMT compartment, and zone were compared between groups using chi-squared tests. The association between IKDC-SKF score, demographics, and surgical characteristics was evaluated using multivariable linear regression. A-priori alpha level was p < 0.05.

Results

Forty-one patients met inclusion criteria and had complete datasets and were therefore included in this
analysis. The meniscal repair and meniscectomy groups differed based on graft source (p = .003) and
meniscus tear zone (p<.001) but not IKDC score (p = .29; Table 1). The final adjusted regression model
predicted 36.6% of variance in IKDC score with longer time from injury to ACLR (p = 0.049), shorter time
to follow-up (p = .002), bucket handle tear zone (p = 0.04), and meniscectomy (p = 0.008) associated with
poorer IKDC scores (Table 2).

Conclusion

BHMT repair was more likely performed in ACL autograft recipients and on red-red zone tears. Longer time from injury to surgery, shorter time to follow-up, bucket handle tear zone, and meniscectomy are indicators of poorer IKDC-SKF score, although longer follow up is necessary to see the long-term impact.