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Acceptable Clinical Outcomes Despite High Reoperation Rate at Minimum 12-Month Follow-Up after Concomitant Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction and Medial Meniscal Allograft Transplantation


Kirk Anthony Campbell, MD
UNITED STATES

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Acceptable Clinical Outcomes Despite High Reoperation Rate at Minimum 12-Month Follow-Up after Concomitant Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction and Medial Meniscal Allograft Transplantation

Dhruv Sundar Shankar, BS, UNITED STATES Kinjal Vasavada, BA, UNITED STATES Amanda Avila, MPH, UNITED STATES Brittany DeClouette, MD, UNITED STATES Hadi Aziz, BS, UNITED STATES Eric Jason Strauss, MD Michael J Alaia, MD, UNITED STATES Laith M. Jazrawi, MD, UNITED STATES Guillem Gonzalez-Lomas, MD, UNITED STATES Kirk Anthony Campbell, MD, UNITED STATES

NYU Langone Health Department , New York, New York, UNITED STATES

2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Sports Medicine

Orthopaedic Sports Medicine Outcome Studies

Diagnosis / Condition

Tears

Treatment / Technique

Allograft Arthroscopy Repair / Reconstruction

Anatomic Location

Knee

Anatomic Structure

Ligaments Meniscus

Diagnosis Method

MRI

Ligaments

ACL

Summary: This study showed that concomitant ACLR and medial MAT procedure is associated with excellent knee pain and functional outcomes and high rate of return to work after surgery despite high reoperation rate.

Background

Single-stage medial meniscus allograft transplantation (MAT) with concomitant anterior cruciate ligament reconstruction (ACLR) is a technically-challenging procedure for management of knee pain and instability in younger patients, but clinical and functional outcomes data is sparse. The purpose of this study was to assess surgical and patient-reported outcomes following concomitant ACLR and medial MAT.

Methods

We conducted a retrospective case series of patients who underwent medial MAT with concomitant primary or revision ACLR at our institution from 2010-2021 and had minimum 12-month follow-up. Complications, reoperations, Visual Analog Scale (VAS) pain, satisfaction, Lysholm score, return to sport, and return to work outcomes were assessed. Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference, Pain Intensity, and Physical Function Scores were used to measure patients’ functional status relative to the U.S. population. P-values <0.05 were considered significant.

Results

The cohort consisted of 17 knees of 16 individual patients. The cohort was majority male (82.4%) with mean age of 31.9 years (range 19-49) and mean body mass index (BMI) of 27.9 (range 22.5-53.3). Mean follow-up time was 56.8 months (range 13-106). Most patients underwent revision ACLR (64.7%). The one-year reoperation rate was high (23.5%) with two patients (11.8%) tearing their meniscus graft. Patient-reported outcomes indicated low VAS pain (mean 2.2), high satisfaction (mean 77.9%), and fair Lysholm score (mean 81.1). Return to work rate was high (92.9%) while return to sport rate was low (42.9%). Postoperative PROMIS scores were comparable or superior to the national average and correlated significantly with patient satisfaction (p < 0.05).

Conclusions

The concomitant ACLR and MAT procedure is associated with excellent knee pain and functional outcomes and high rate of return to work after surgery though the one-year reoperation rate is high and rate of return to sport is low.

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