2019 ISAKOS Biennial Congress ePoster #1059
Repair for Posterior Lateral Meniscus Radial/Flap Tears Combined with ACL Reconstruction: Arthroscopic Evaluations at Two-Year Post-Operation
Akira Tsujii, MD, PhD, Hirakata, Osaka JAPAN
Yasukazu Yonetani, MD, PhD, Hirakata, Osaka JAPAN
Kazutaka Kinugasa, MD, PhD, Sakai, Osaka JAPAN
Tomohiko Matsuo, MD, PhD, Hirakata, Osaka JAPAN
Kenji Yoneda, MD, Osaka JAPAN
Tomoki Ohori, MD, Suita, Osaka JAPAN
Masayuki Hamada, MD, Hirakata, Osaka JAPAN
Hoshigaoka Medical Center, Hirakata, Osaka, JAPAN
FDA Status Cleared
The meniscal function might decrease although successful clinical outcomes and meniscal healing could be achieved after repairing posterior lateral meniscus radial/flap tears combined with ACL reconstruction 2 years postoperatively.
Radial/flap tears of posterior lateral meniscus (LM) are occasionally seen with a tear of anterior cruciate ligament (ACL). Short term results of meniscal healing after repairing those tears have already been reported, however, it still remains unknown whether the meniscal function could be preserved. The aim of this study was to evaluate not only meniscal healing but cartilage status after repairing radial/flap tears of posterior LM combined with anatomical ACL reconstruction (ACLR) at 2-year follow-up.
Thirty patients who underwent inside-out or all-inside repair of radial/flap tears of posterior LM combined with primary ACLR using bone-patellar-bone graft or semitendinosus tendon graft were retrospectively reviewed. All patients had no pain and swelling with no instability at final follow-up. There were 12 male and 18 female patients with a mean age of 29.0. Meniscal healing status and cartilage status were assessed by second-look arthroscopy at average 2 years postoperatively. Healing status was classified as complete healing, partial healing and failure, based on both the healing at the repair site and the condition of the meniscal body. Cartilage status was assessed in the lateral femoral condyle (LFC) and the lateral tibial plateau (LTP) with ICRS classification at the time of primary surgery and second-look surgery.
Eighteen (60%) were considered to be completely healed, and 9 (30%) were partially healed on second-look arthroscopy. No significant difference in the alteration of cartilage status was seen at LFC (ICRS grade was improved in 6, no change in 22 and worsened in 2; p > 0.1). However, cartilage status at LTP was significantly worsened (ICRS grade was improved in 3, no change in 9 and worsened in 18; p < 0.01).
Despite high healing rate of repaired meniscus, the lateral tibial plateau cartilage status was significantly worsened at the second-look arthroscopy 2 years postoperatively. We should keep in mind that the meniscal function might decrease although successful clinical outcomes and meniscal healing could be achieved.