2025 ISAKOS Congress in Munich, Germany

2025 ISAKOS Biennial Congress Paper


Meniscal Repair Failure Rate Among Professional Athletes Undergoing ACL Reconstruction: A Cohort Study of 196 Patients From the Santi Study Group With a Mean Follow up of 96 Months

Jae-Sung Jaesung, MD, PhD, Tokyo, 東京都 JAPAN
Mohammed Lahsika, Médecin résident, Fez MOROCCO
Alice Nlandu, MD, Lyon FRANCE
Giancarlo Giurazza, MD, rome ITALY
Julien Chamoux, MD, Lyon FRANCE
Marc Barrera Uso, MD, Fribourg SWITZERLAND
Silvia Cardarelli, MD, Rome ITALY
Thais Dutra Vieira, MD, Lyon, Rhone FRANCE
Bertrand Sonnery-Cottet, MD, PhD, Lyon, Rhône FRANCE

Centre Orthopédique Santy, Lyon, FRANCE

FDA Status Not Applicable

Summary

This study included the largest cohort to date to evaluate the clinical outcomes of meniscal repair combined with ACL reconstruction in professional athletes and demonstrated that the incidence of secondary meniscectomy was 15.4% for the MM and 5% for the LM during long-term follow-up. No risk factors for secondary meniscectomy were found.

Abstract

Background

Due to the lack of sufficient evidence, there is still controversy regarding the ideal management method for meniscal tears combined with anterior cruciate ligament (ACL) injury, especially for professional athletes.
Purpose/Hypothesis: The primary objective of this study was to describe the incidence of secondary meniscectomy in professional athletes undergoing a meniscal repair concomitant to primary ACLR. The second objective was to identify the associated risk factors for failure of medial (MM) and/or lateral (LM) meniscal repair in this specific population at long-term follow-up.
Study design: This was a retrospective cohort study (level of evidence: 4).

Methods

This was a retrospective comparative study. All patients who were defined as professional athletes underwent arthroscopic primary ACL reconstruction and repair of medial and/or lateral meniscal tears from January 2005 to November 2020. Risk factors associated with secondary meniscectomy were analyzed using a logistic regression model.

Results

196 patients had a meniscal repair out of 230 professional athletes undergoing primary ACL reconstruction (85.2%). The mean age was 23.3 (SD 5.0) years, and the mean Tegner score was 9.3 (SD 1.0). The most common type of graft used was hamstring tendon grafts (74%), and 74% of patients underwent a concomitant lateral extra-articular procedure. Among the 196 patients with meniscal lesions, 37% had lateral meniscus (LM) lesions, 29% had medial meniscus (MM) lesions, and 34% had lesions in both LM and MM. LM tears were repaired in 92.6% of cases, while 7.3% were left in situ. The most common type of repair for LM tears was the all-inside technique. MM tears were repaired in 92.6% of cases, with 2.5% left alone, and no meniscectomies were performed. The most common type of repair for MM tears was the suture hook technique. At a mean follow-up of 95.8 (SD 45.1) months, 26 patients (13.2%) underwent a secondary meniscectomy: 7 (5.0%) for LM and 19 (15.4%) for MM. A Cox model revealed no significant risk factors associated with secondary lateral or medial meniscectomy.

Conclusions

This study showed that among this retrospective analysis of professional athletes with an ACL rupture, 85.2% (196/230) had meniscal lesions, with 37% having LM tears, 29% MM tears, and 34% having lesions in both menisci. At long-term follow-up, the meniscal repair failure rate in this population of patients who underwent primary ACL reconstruction was 13.2% overall, 5% for LM tears and 15.4% for MM tears. No risk factors for secondary meniscectomy were found.