Summary

Medial meniscal repairs with concurrent ACLR displayed significant failure rates as compared to lateral or bilateral meniscal repairs.

Abstract

Introduction

Meniscal and anterior cruciate ligament (ACL) tears tend to occur concomitantly up to 77% of the time. The purpose of this study is to evaluate a variety of predictive factors that may influence meniscus failure in concomitant hamstring autograft ACLR.

Methods

Patients who underwent meniscal repair with concomitant ACLR during the study period of 2012 to 2022 at our single academic center were identified. Inclusion criteria included patients who had received at least 1 year follow-up and who had the following variables documented: gender, smoking status, sport involvement, previous knee injury/surgery/repair, laterality of repair, concurrent additional surgery (i.e. MCL, LCL, PCL) and meniscal tear type. Both total and stratified measurements (i.e. separated by medial, lateral, and bilateral meniscal repairs) of stated variables were analyzed against failure rates with statistical significance determined to be p-value <0.05.

Results

663 patients met inclusion criteria, with 311 patients (170 male, 141 female) having an average age of 24.2 (±8.7) years and BMI of 29.9 (±4.2) regarded in final analysis. Preliminary findings indicate statistically significant failure rates with laterality of repair (p=.022*) and medial meniscal tear type (p=.04*). Medial meniscal tears failure 25.2% of the time, while lateral and bilateral repairs failed 9.8% and 19.6% of the time, respectively. bucket handle, horn, and complex tear types were associated with the highest failure rates of 45.5%, 42.9%, and 26.5% respectively. Notably, lateral meniscal repairs encompassed a different array of tear types associated with high failure rates, i.e. Vertical (26.9%), Horizontal Cleavage (16.7%), Complex (12.5%), but were not statistically significant.

Conclusions

Medial meniscal repairs with concurrent ACLR displayed significant failure rates as compared to lateral or bilateral meniscal repairs. Of these repairs, bucket handle, horn, and complex types displayed highest re-tear rates, with tear types varying between laterality of meniscal repair.