Summary

More perforation grade of the lateral meniscus with single bundle reconstruction were appeared than that with double bundle reconstruction. However, there was no difference in the extrusion change of lateral meniscus between single bundle and double bundle reconstruction.

Abstract

Background

The tibial attachment of the anterior cruciate ligament and the anterior horn of the lateral meniscus (AHLM) were reported to be close to each other. This study aimed to evaluate the relationship between the tibial bone tunnel and AHLM perforation and to investigate AHLM perforation during surgery and extrusion of lateral meniscus one year after ACL reconstruction.

Methods

A retrospectively collected database and associated intraoperative findings for 56 patients undergoing primary anatomical ACL reconstruction with a single or double bundle from 2015 to 2020 were investigated. Those cases had no meniscal injury seen at surgery and more than a one-year follow-up. We calculated the percentage of perforation by the length of attachment of AHLM before and three months after surgery using MRI. The perforations were graded using perforation rate (grade 0 was no perforation, grade 1 was less than 1/3, grade 2 was more than 1/3 and less than 2/3, grade 3 was more than 2/3), and the lateral meniscal extrusion changes from preoperative to one year after surgery were compared between the single bundle and the double-bundle ACL reconstruction. The location of the center of the tibial tunnel was evaluated by the position relative to the medial tibial eminence with two measures, the medial-lateral and the anterior-posterior distance with the 3D-CT image.

Results

The number of meniscal perforation grade 1 or higher was significantly higher in the single bundle group than that in the double-bundle group (single 10/14 vs double 6/42, P<0.001). There was no significant correlation between extrusion of lateral meniscus and perforation rate. The tibial tunnel was almost the same relative to the previous study.

Conclusion

More perforation grades of the lateral meniscus with single bundle reconstruction appeared than that with double-bundle reconstruction. However, there was no difference in the extrusion change of lateral meniscus between single bundle and double-bundle reconstruction.