Summary: Satisfactory midterm clinical and radiological outcomes with no re-tears and progression to knee OA have been observed after simultaneous repair of lateral meniscus posterior root and ACL tear.

Background

The combination of lateral meniscus posterior root (LMPR) and anterior cruciate ligament tear is commonly seen in clinical practice. Biomechanical studies have demonstrated the importance of meniscal root repair as it provides secondary stability to the ACL during pivot shift loading. On the other hand, meniscal tears repaired at the time of ACL reconstruction have demonstrated improved outcomes when compared with those repaired in isolation. It has been theorized that the reason behind these improved outcomes relates to a favorable healing environment created by biological augmentation of the repair from the intra-articular release of the bone marrow when drilling the ACL tunnels. However, no clinical outcomes to date have been reported.

The purpose of the study was to evaluate clinical and radiological outcomes of LMPR repair in the ACL-reconstructed knee

Methods

Between 2016 and 2018, 17 patients with LMPR and ACL tear who had been followed up for at least 2 years were evaluated. Primary clinical outcomes at a minimum of 29.4 (SD ± 5.5) months postoperatively included Knee injury and Osteoarthritis Outcome Score (KOOS) and Lysholm Knee Questionnare (LKQ). Radiographic assessment of the knee was performed to determine osteoarthritis severity using the Kellgren-Lawrence (KL) grading system. In addition, pre and postoperative MRI scans, and intraoperative arthroscopic findings were documented.

Results

There were 13 male patients (76.5%) and 4 female (23.5%) with a mean age of 32.1 (SD ± 9.9). Left knee was involved in 11 cases (64.7%) and right in 6 (35.3%). In all cases tears were traumatic. According to LaPrade classification system 2 patients (11.8%) presented type 2 tear, 6 (35.3%) type 3, and 9 (52.9%) type 5.

Postoperatively the mean Lysholm score was set at 91.6 ± 9.8 and total KOOS score at 82.9 ± 11.3. No significant radiological progression of arthritic changes was observed postoperatively using KL score (P=346). None of the patients referred postoperative knee instability during daily activities and no re-tear was observed on MRI at the final follow-up. Regarding postoperative MRI findings 2 patients (11.8%) presented meniscal extrusion, and only 1 case (5.9%) of osteochondral defect was documented postoperatively.

Conclusion

Satisfactory midterm clinical and radiological outcomes with no re-tears and progression to knee osteoarthritis have been observed after concomitant repair of lateral meniscus posterior root and ACL tear.

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Concomitant Medial Meniscal Ramp Lesions and Lateral Meniscal Tears with Anterior Cruciate Ligament Injuries are Associated with Anterior Tibial Subluxation in Knee Extension ePoster Presentation Hibiki Kakiage, MD, JAPAN Kazuhisa Hatayama, MD, PhD, JAPAN Satoshi Nonaka, MD, JAPAN Masanori Terauchi, MD, JAPAN Atsufumi Oshima, MD, JAPAN HIrotaka Chikuda, MD, PhD, JAPAN
Biomechanics Of Different Surgical Techniques For Posterior Medial Meniscal Root Repair: A Porcine Model ePoster Presentation Nadhaporn Saengpetch, THAILAND Sutip Noowan, Md, THAILAND Chaiyanun Vijittrakarnrung, MD, THAILAND
Morphological Analysis of Discoid Lateral Meniscus on Magnetic Resonance Imaging Comparing Pre- and Postoperative Images ePoster Presentation Shunya Tsuji, MD, JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Naofumi Hashiguchi, MD, JAPAN Goki Kamei, MD, PhD, JAPAN Atsuo Nakamae, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN
Comparison Of Resultant Force Through The Repaired Lateral Meniscus With Between Inside-Out And All-Inside-Suture Techniques ePoster Presentation Takehito Hirose, MD, PhD, JAPAN Tatsuo Mae, MD, PhD, JAPAN Satoshi Yamakawa, PhD, JAPAN Issei Ogasawara, PhD, JAPAN Shoji Konda, PhD, JAPAN Yasuhiro Take, MD, PhD, JAPAN Ken Nakata, MD, PhD, JAPAN
Can Local Anesthesia be Considered as Gold Standard in Knee Arthroscopy? ePoster Presentation Tilemachos Papageorgiou, MD, GREECE Stefanos Christos Papageorgiou, MD, GREECE ILIAS SOTIRIADIS, MD, GREECE Tsoumanis Dimitrios, MD, GREECE Christos D. Papageorgiou, MD, PhD, GREECE
Knee Cartilage and Meniscus in Recreational marathon runners: a MRI T2 * mapping investigation ePoster Presentation Siyu Dai, PhD, CHINA Feng Chen, PhD, CHINA Dingbo Shu, MD, CHINA Fanjing Meng, MD, CHINA Le Wang, MD, CHINA Yanjing Zhang, MD, CHINA Jianping Ding, MD, CHINA
Biological Augmentation May Play A Role In Obtaining Superior Clinical Outcomes In Meniscal Root Repair With Concomitant Anterior Cruciate Ligament Reconstruction ePoster Presentation Lika Dzidzishvili, MD, SPAIN Irene Isabel López-Torres, MD, PhD, SPAIN David Sáez, MD, SPAIN Antonio Hernández Diez, MD, SPAIN Emilio Calvo, MD, PhD, MBA, SPAIN
Cross-Sectional Effects of Isolated Meniscal Tears on In Vivo Biomechanics of the Knee: A Systematic Review Of Motion Analysis Studies ePoster Presentation Enzo Salviato Mameri, MD, MSc, BRAZIL Garrett Jackson, MD, UNITED STATES Harkirat Jawanda, BS, UNITED STATES Jonathan A Gustafson, PhD, UNITED STATES Leonardo Metsavaht, MD PhD, BRAZIL Jorge Chahla, MD, PhD, UNITED STATES
Biomechanical Effect of Unstable Meniscal Injury on Gait in ACL-Deficient and -Reconstructed Knees ePoster Presentation Kengo Harato, MD, PhD, JAPAN Kohei Nishizawa, PhD, JAPAN Shu Kobayashi, MD, PhD, JAPAN Yasuo Niki, MD, PhD, JAPAN Takeo Nagura, MD, JAPAN
Outcomes of Arthroscopic All-Inside Repair are Improved Compared to Transtibial Pull-Out Repair of Medial Meniscus Posterior Root Tears ePoster Presentation Kyoung-Ho Yoon, MD, PhD, Prof., KOREA, REPUBLIC OF Jae-Young Park, MD, KOREA, REPUBLIC OF Cheol Hee Park, MD, PhD, KOREA, REPUBLIC OF Sang-Gyun Kim, MD, PhD, KOREA, REPUBLIC OF Yoon-Seok Kim, MD, KOREA, REPUBLIC OF Hee Sung Lee, MD, KOREA, REPUBLIC OF Sung Hyun Hwang, MD, KOREA, REPUBLIC OF Dae Keun Suh, MD, PhD, KOREA, REPUBLIC OF Bo Seung Bae, MD, KOREA, REPUBLIC OF
Clinical Result of the Two Stage ACL Reconstruction and Meniscus Allograft Transplantation, Is It Comparable To The Meniscus Allograft Transplantation Alone? ePoster Presentation S. Ali Ghasemi, MD, UNITED STATES Shervin Rashidinia, MD, IRAN, ISLAMIC REPUBLIC OF Adel Mahjoub, MD, UNITED STATES Lawrence S. Miller, UNITED STATES
Clinical Outcomes After the Repair of Isolated Full Radial Tear at Midbody of Lateral Meniscus - All-Inside Suture Repair vs Trans-Capsular Suture Repair - ePoster Presentation Ryohei Uchida, MD, PhD, JAPAN Shuji Horibe, MD, PhD, JAPAN Yoshinari Tanaka, MD, PhD, JAPAN Kazutaka Kinugasa, MD, PhD, JAPAN Yuta Tachibana, M.D., Ph.D., JAPAN Akira Tsujii, MD, PhD, JAPAN Konsei Shino, MD, PhD, JAPAN
Less Than 10% Failure Rate in Patients with Bucket-Handle Meniscal Tear Repair After 4 Years Follow-Up ePoster Presentation Tomas Alfredo Esteves, MD, ARGENTINA Ignacio Astore, ARGENTINA Carlos H. Yacuzzi, MD, ARGENTINA Matias Costa-Paz, MD, PhD., ARGENTINA Juan Pablo Zicaro, MD, ARGENTINA
Predictors of Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction With Concurrent Treatment of Bucket-Handle Meniscus Tears ePoster Presentation Gregory Perraut, MD, UNITED STATES Rachel E Cherelstein, BS, UNITED STATES Alexandra Galel, MD, UNITED STATES Laura Keeling, MD, UNITED STATES Christopher M Kuenze, PhD, UNITED STATES Andrew Curley, MD, UNITED STATES David X. Wang, MD, UNITED STATES Kaitlin A Malekzadeh, , UNITED STATES Edward S. Chang, MD, UNITED STATES
Meniscus Transplants Delay Arthroplasty in Patients Over 50 Years of Age ePoster Presentation Kevin R. Stone, MD, UNITED STATES Ann W. Walgenbach, RN, NP, MSN, UNITED STATES Shadera Slatter, MS, UNITED STATES Thomas J. Turek, PhD, UNITED STATES Caroline Ferguson-Dryden, BA, UNITED STATES Marie Dicker, BASc, UNITED STATES Emma Miltenberger, BS, UNITED STATES Riley Horn, BS, UNITED STATES Haley Cowles, BA, UNITED STATES Vivian Liu, BA, UNITED STATES Stephanie Wu, BS, UNITED STATES Mani Vessal, MA, PhD, UNITED STATES
Good Clinical Results After Combined Arthroscopic Meniscal Allograft Transplantation and Autologous Chondrocyte Implantation Using Chondrospheres ePoster Presentation Rainer Siebold, Prof. Dr. med., GERMANY Johannes Pawelczyk, cand. med., GERMANY
Continuous Vertical Inside-Out Versus Traditional Vertical Inside-Out Meniscal Repair: A Biomechanical Comparison ePoster Presentation José Leonardo Rocha De Faria , MD, MSc, BRAZIL Arthur Paiva Grimaldi Santos, M.Sc., BRAZIL Douglas Mello Pavão, MD, MSc, PhD, BRAZIL Mariana Radulski, Medical Student, BRAZIL Ana Carolina Leal, PhD, BRAZIL Ari Digiácomo Ocampo Moré, PhD, BRAZIL Alan de Paula Mozella, PhD, Prof., BRAZIL Joao ANTONIO MATHEUS GUIMARAES, BRAZIL Robert F. LaPrade, MD, PhD, UNITED STATES Carlos Rodrigo de Mello Roesler, PhD, BRAZIL Rodrigo Salim, MD,PhD, BRAZIL

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Clinical Outcomes Of Lateral Meniscus Posterior Root Repair In The Acl-Reconstructed Knees

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