Summary

Descriptive study developed in Hospital Clinico IST Viña Del Mar, Chile. We present the clinical outcomes and patient satisfaction in 41 patients with ACL reconstruction plus meniscal suture with outside in technique after a 5 year follow up.

Abstract

Anterior cruciate ligament reconstruction associated with meniscal suture is a procedure that is frequently performed in patients with these combined injuries. As it has been seen in literature, the association of meniscal lesions to ACL rupture reaches 20-45% for the lateral meniscus and 0-28% for the medial meniscus.
Nowadays, meniscal preservation through its repair is a relevant objective when treating these injuries, which are usually presented in patients who practice sports and require an optimal result to continue carrying out their daily and sports activities.
The purpose of this study is to evaluate the clinical results and satisfaction of the patients who had both procedures combined at 5 years of follow-up.
A descriptive, monocentric study was carried out where 41 patients were selected to be operated in the Clinical Hospital IST Viña del Mar - Chile by the same surgical team between January 2014 and December 2015, who presented an ACL injury with associated meniscal tear (medial or lateral), to whom an arthroscopic ACL reconstruction with a semitendinosus gracilis autograft and inside-out technique suture was performed. In the postoperative period, all patients followed the same rehabilitation protocol.
Clinical results were evaluated according to the Tegner Lysholm Knee Score and the KOOS Score (Knee Injury and Osteoarthritis Outcome Score) five years after surgery. Patient satisfaction was evaluated by means of a simple survey in which they had to express whether they were not satisfied, satisfied or very satisfied with the result of their surgery after the time elapsed. Patients who had to undergo further surgery on the affected knee during the 5 years of follow-up were excluded from this study.
A total of 41 patients were selected, of which 37 were men and 4 were women, with an age range between 16 and 39 years.
At the five-year follow-up, an average of 92 (range 89 to 100) was found on the Tegner Lyhsholm Knee Score, representing a good to excellent result in all patients. In the final evaluation of the KOOS Score, an average of 87.5 points was observed (range of 85.7 to 100) representing good to excellent results in the group studied. On the other hand, 83% of the patients said they were satisfied or very satisfied with the result of the surgery after 5 years of follow-up.
Through this study we can conclude that patients with ACL ruptures combined with meniscal tears who have a reconstruction plus meniscal suture with inside-out technique, present good to excellent results according to the clinical Scores applied to the studied group, after 5 years of follow-up. In addition, as for the patients' perception of satisfaction, the result is excellent in the great majority of those surveyed.
Finally, we must emphasize that in patients with ACL rupture and associated meniscal injury it is important to preserve the meniscus whenever possible, thus improving satisfaction and clinical results observed in the medium term.