2017 ISAKOS Biennial Congress Paper #128

 

Meniscus Repair Outcomes in the Revision ACL Reconstruction Setting: Results from the Mars Group

Rick W. Wright, MD, St. Louis, MO UNITED STATES
Washington University, St. Louis, MO, UNITED STATES

FDA Status Not Applicable

Summary

Meniscus repair results in the revision ACL reconstruction setting from the MARS Group are consistent with results noted in primary reconstruction

Abstract

Introduction

Meniscal preservation has been demonstrated to contribute to long term knee health. This has been a successful intervention in the isolated and ACL reconstructed patient. The results of meniscus repair in the setting of revision anterior cruciate ligament reconstruction have never been documented to any significant extent. The MARS group offers with its large cohort of revision anterior cruciate ligament reconstructions the opportunity to explore this issue.

Methods

The MARS Group was assembled with the aim of determining what impacts outcome in an ACL revision setting, and to identify potentially modifiable factors that could improve these outcomes. This collaboration consists of a group of 83 sports medicine fellowship trained surgeons across 52 IRB approved sites. Surgeons are a near equal mix of academic and private practitioners. Surgeons document surgical technique and intraarticular findings including meniscal and chondral damage and their treatment

Results

1215 patients were enrolled. 235 repairs were performed in 218 patients (19.5% of the cohort) 170 were medial, 65 lateral and 17 medial and lateral. 178 (76%) were performed with all-inside techniques. 17 repairs failed by 2 year follow up. 15 medial (8.8%) 13 all inside, 2 outside in, 2 lateral (3.1%) both all inside. 4 of the medial failures were treated in conjunction with a subsequent repeat revision reconstruction.

Conclusions

Meniscus repair in the revision setting is a successful treatment choice when appropriate. Failure rates for medial and lateral tears were both less than 10% and consistent with primary ACL reconstruction meniscus repair success rates. Medial tears underwent reoperation for failure at a statistically significant higher rate than lateral tears.