Risk Factors for Re-Tear of the Meniscus Following Meniscus Repair with Concomitant ACL Reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Meniscal tears are common injuries, often treated with repair alongside anterior cruciate ligament (ACL) reconstruction.
• Understanding factors influencing meniscal repair outcomes is crucial for optimizing patient care.
• Previous studies have explored re-tear rates, but specific surgical and demographic influences require further investigation.

Purpose of the Study:

• To determine the incidence of meniscal re-tear in patients undergoing concurrent ACL reconstruction and meniscal repair.
• To identify surgical and patient demographic factors associated with meniscal repair failure.

Main Methods:

• Retrospective review of 191 patients who had meniscal repair and ACL reconstruction over seven years.
• Analysis of variables including patient demographics, graft type, repair site, and surgical techniques.
• Definition of repair failure as the need for revision surgery on the same meniscus.

Main Results:

• An overall meniscal re-tear rate of 38.2% was observed.
• Higher failure rates were associated with allograft use for ACL reconstruction (54%) compared to autografts (23-30%).
• Medial meniscus repairs had a higher re-tear rate (46%) than lateral repairs (17%).
• Pediatric patients (<18 years) showed a significantly higher re-operation rate of 49%.

Conclusions:

• The study highlights a substantial failure rate for meniscus repairs in conjunction with ACL reconstruction.
• Key risk factors for meniscal re-tear include medial meniscus involvement and the use of allografts for ACL reconstruction.
• The high re-tear rate in pediatric patients necessitates further research and potentially tailored treatment strategies.