Summary

Higher age, medial meniscus repair and when the repair was done isolated without concomitant ACL reconstruction increases the odds of failure after meniscal repair.

Abstract

Objectives:
To evaluate the overall failure rate within three years of meniscus repair in a large cohort. Additionally, possible factors influencing meniscus repair outcome were assessed.

Methods

Patients who underwent meniscal repair at one high volume arthroscopic institution, from January 2015 to June 2022, were identified. The primary outcome was the occurrence of failure of repair, defined as a need for reoperation and secondary partial or total meniscal resection within three years from the primary repair. Kaplan-Meier analysis was performed to assess repair survival, with multivariate Cox regression to adjust for confounders.

Results

A total of 2264 meniscal repairs were included. 1265 (55.9%) patients were male and 999 (44.1%) were female with a mean age of 27 years (range, 8-61 years). The failure rate for the entire cohort was 20.2 %,The failure rate for the entire cohort was 19.2 %, with a significantly higher failure rate for patients older than 40 years (27.1%, p=0.005) at the time of repair. There was also a significantly higher risk for failure for medial meniscus repairs (p=<0.001) and if no concomitant ACL reconstruction was conducted (p=<0.001).
Multivariate Cox regression revealed that reoperation after meniscal repair was significantly related to age >40 (HR 1.32; 95% CI 1.00-1.76; P=0.04), medial meniscus repair (HR 2.51; 95% CI 2.01-3.19; P<0.001) and when no concomitant ACLR was performed (HR 2.73; 95% CI 2.22-3.35; P<0.001. Other age groups or gender did not affect the outcome.

Conclusions

Higher age, medial meniscus repair and when the repair was done isolated without concomitant ACL reconstruction increases the odds of failure after meniscal repair.