Meniscal repair with concomitant suture-augmented ACL repair versus reconstruction: a retrospective cohort study

This study evaluated patient-reported outcome measures (PROM) and reinjury rates in patients undergoing meniscal repair with concomitant suture-augmented (SA) anterior cruciate ligament reconstruction (ACLR) or repair (ACLr).

We performed a retrospective cohort study of patients who underwent concomitant meniscus and ACL procedures by a single surgeon between 2015 and 2021. Inclusion criteria were meniscal repair with concomitant SA ACLR or SA ACLr, at least two years of follow-up, and participation in postoperative PROM surveys. Exclusion criteria were concomitant meniscectomy, multiligament repair or reconstruction, or other concomitant procedures at the time of the index operation. After a minimum of two years of follow-up, data was collected on reinjury and patient reported outcome measures, including Knee Injury and Osteoarthritis Outcome Score (KOOS), Single Assessment Numeric Evaluation (SANE), Visual Analog Pain Scale, and Veterans Rand 12 Item Survey (VR-12).

39 total patients were identified, 12 ACL repairs and 27 ACL reconstructions. 6 patients were lost to follow-up, with 10 patients in the ACLr cohort and 23 patients in the ACLR cohort included in the study. Meniscus tear laterality was not significantly different between the cohorts (p = 0.3828). There were two meniscal repair failures in the ACLr cohort compared to one in the ACLR cohort (p = 0.2117). There was one ACL reinjury in the ACLr cohort compared to zero reinjuries in the ACLR cohort (p = 0.3030). In a univariate analysis of PROMs, there were no significant differences in postoperative KOOS (p = 0.3308), VAS (p = 0.9955), SANE (p = 0.3449), VR-12M (p = 0.4705), or VR-12P (p = 0.7903) scores between the cohorts. In a multivariable analysis controlling for age, sex, BMI, meniscus tear laterality, and meniscus tear pattern, choice of ACL procedure was not a significant predictor of any postoperative PROM. 23 total patients, 6 ACL repairs and 17 ACL reconstructions had preoperative data available and were evaluated for changes in PROMs after surgery. There were clinically significant improvements in KOOS and SANE scores in both cohorts postoperatively.

In this cohort of patients, meniscal repair with SA ACLr was not inferior to meniscal repair with SA ACLR at two years of follow-up.