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Concomitant partial meniscectomy worsens outcome after arthroscopic anterior cruciate ligament reconstruction
Jüri T Kartus1, Vivianne J Russell, Lucy J Salmon
1Australian Institute of Musculo-Skeletal Research, Sydney. juri.kartus@trollhattan.mail.telia.com
Abstract:
In this multi-center study involving 412 patients, we assessed the influence of concomitant partial meniscal resection on the medium-term clinical results after anterior cruciate ligament reconstruction. We performed a resection of minimum one-third of the medial or lateral menisci in 137 patients (group M) and found intact menisci in 275 patients (group NM). Those who had undergone previous meniscal surgery, subsequent meniscal surgery or a re-rupture of the anterior cruciate ligament graft during the follow-up were not included. After a median of 3 (2-6) years, the patients were reexamined by independent observers. Group M patients had more pain, swelling and laxity than those in group NM; they also had a worse classification according to the IKDC system, lower Lysholm scores and a greater proportion of patients with loss of motion.
Insights
Partial meniscal resection during anterior cruciate ligament reconstruction negatively impacts medium-term outcomes. Patients with meniscal resection reported more pain, swelling, and laxity, with poorer functional scores.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Knee Reconstruction
Background:
- Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
- The role of concomitant meniscal resection in ACL reconstruction outcomes requires further clarification.
Purpose of the Study:
- To evaluate the medium-term clinical results of ACL reconstruction with and without partial meniscal resection.
Main Methods:
- A multi-center study of 412 patients undergoing ACL reconstruction.
- Patients were divided into two groups: partial meniscal resection (Group M, n=137) and intact menisci (Group NM, n=275).
- Exclusion criteria included prior/subsequent meniscal surgery or graft re-rupture. Clinical outcomes were assessed by independent observers after a median of 3 years.
Main Results:
- Group M patients experienced significantly more pain, swelling, and knee laxity compared to Group NM.
- IKDC (International Knee Documentation Committee) system scores were worse in Group M.
- Lysholm scores were lower, and a greater proportion of patients in Group M reported loss of motion.
Conclusions:
- Concomitant partial meniscal resection during ACL reconstruction is associated with inferior medium-term clinical outcomes.
- These findings suggest preserving meniscal tissue is crucial for optimal patient recovery and function after ACL reconstruction.