2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Re-Operation Rate and Correlating Factors for Healing Following Meniscus Repair: A Retrospective Analysis of 2492 Cases

Bjørn Borsøe Christensen, MD, PhD, Horsens DENMARK
Christopher Holst Hansen, MD, Horsens DENMARK
Anders El-Galaly, MD, PhD, Aarhus DENMARK
Martin Lind, MD, PhD, Prof., Aarhus N DENMARK
Martin Lundorff, MD DENMARK

Horsens Regional Hospital, Horsens, DENMARK

FDA Status Not Applicable

Summary

We reviewed 2492 meniscus repair procedures in the Denmark Central Region and found a total reoperation rate of 31,9% after 5 years. There were no correlation to patient age, sex, age of injury or BMI. Smokers had a 24% increased risk of failure. Concurrent ACL reconstruction resulted in a lower reoperation rate.

Abstract

Background

Meniscal injuries are common in orthopedic practice, with conservative treatment, surgical repair or resection being the standard treatments. Resection of the meniscus can lead to the development of early arthritis and there is an increasing focus on saving the meniscus. However, the reoperation rate following meniscus repair remains a concern, impacting patient outcomes and healthcare resources.

Aim

This retrospective study aimed to evaluate the reoperation rate after meniscus repair and identify potential risk factors associated with reoperation.

Materials And Methods

We conducted a retrospective analysis of 2492 cases undergoing meniscus repair between 2011 and 2023 in the Central Denmark Region (6 different hospitals). Data on patient demographics, including age at operation, sex, BMI, type of injury, number of sutures, concomitant ACL injury, age of injury, and smoking status, were collected. Reoperation due to failure of the meniscus suture were recorded. Kaplan-Meyer analysis was performed and multivariate Cox regression adjusted for confounders.

Results

A total of 2492 meniscus repairs were analyzed. The reoperation rate following meniscus suture at 1 year was 13,2% CI [11.9 , 14.6], at 2 years 22,4% CI [20.7 , 24.0] and at 5 years 31,9% CI [27.17 , 33.0]. The mean time until reoperation was 1.68 years (SD±1.62). We found no significant correlation between reoperation rates and age of patient (p=0.28), age of injury (p=0.47), BMI (p=0.78), or sex (p=0.23). Smokers had a 24% increased relative risk of reoperation (p<0.05). Concurrent ACL reconstruction resulted in a significantly lower reoperation rate (25.72%) compared with isolated meniscus repair (33.74%) (p<0.001). The risk of reoperation was significantly higher in medial meniscus repair (35.84%) compared with lateral meniscus repair (21.20%) (p<0.001)

Discussion

A reoperation rate of 31% after meniscus suture is relatively high and the lack of correlation to age of injury, age of patient and BMI is noteworthy. Previous assumptions of better clinical outcome in young patients with a normal range BMI and an acute injury, are not supported by the findings of this study.