Recent Trends in Concomitant Meniscal Procedures During Anterior Cruciate Ligament Reconstruction

Area of Science:

• Orthopedic surgery
• Sports medicine
• Epidemiology

Background:

• The meniscus plays a crucial role in knee joint stability and chondroprotection.
• Preserving the meniscus during anterior cruciate ligament reconstruction (ACLR) is increasingly recommended.
• Surgical techniques have advanced, supporting meniscal preservation strategies.

Purpose of the Study:

• To analyze recent trends in partial meniscectomy and meniscal repair performed concurrently with ACLR.
• To investigate demographic shifts in patients undergoing these combined procedures.

Main Methods:

• A descriptive epidemiological study utilizing the National Surgical Quality Improvement Program database (2010-2018).
• Analysis of Current Procedural Terminology (CPT) codes for arthroscopic meniscectomy, meniscal repair, and ACLR.
• Stratification of procedures by year, patient age, and body mass index (BMI), with trend analysis using the Cochran-Armitage test.

Main Results:

• Over 22,000 patients were analyzed; concomitant meniscal surgery rates increased with ACLR.
• The proportion of meniscectomies decreased from 80.8% to 63.8%, while meniscal repairs nearly doubled from 19.2% to 36.2%.
• Meniscal repairs saw increased utilization in older age groups (35-54 years) and among patients with higher BMIs (overweight and obese).

Conclusions:

• There was a significant upward trend in meniscal repair rates during ACLR from 2010 to 2018.
• The increase in meniscal repairs was most pronounced in older, overweight, and obese patient populations.
• These findings suggest a shift towards more conservative meniscal management during ACLR in evolving patient demographics.