Impact of Concomitant Meniscus Repair With Anterior Cruciate Ligament Reconstruction on Functional Outcomes at...

Anterior cruciate ligament (ACL) ruptures are among the most common knee injuries and impose a substantial health burden. ACL injuries are common, and meniscal tears frequently co-occur with acute ACL ruptures, most often involving the medial meniscus. Proper management of combined ACL and meniscus injuries is critical to restore knee function and prevent long-term degeneration. Although concurrent meniscal repair with ACL reconstruction (ACLR) is increasingly favoured over meniscectomy, reported patient-reported outcomes remain inconsistent across registries and are drawn largely from retrospective, Western cohorts, leaving uncertainty about short-term recovery in prospectively followed South Asian populations.

We conducted a single-centre prospective observational study of 115 consecutive patients (mean age = 31.3 ± 10.5 years; range = 17-58) undergoing arthroscopic ACLR with concurrent meniscal repair. All patients were assessed preoperatively and postoperatively at six weeks, three months, and six months using the visual analogue scale (VAS) for pain, the Lysholm Knee Score, and the International Knee Documentation Committee (IKDC) subjective score. Because the Shapiro-Wilk test showed all outcome variables were non-normally distributed at every time point (p < 0.05), non-parametric methods were used: the Friedman test assessed overall change across the four time points, and Wilcoxon signed-rank tests (Bonferroni-corrected) compared each postoperative time point with baseline. Data are summarised as median (interquartile range, IQR); effect sizes are Kendall's W (Friedman) and r (Wilcoxon). A two-tailed p < 0.05 was considered significant.

Of 115 patients, 92 (80.0%) were male, and 23 (20.0%) were female; medial meniscus tears were present in 61 (53.0%), lateral in 39 (33.9%), and combined medial-lateral in 15 (13.0%). All 115 patients completed six-month follow-up with no losses to follow-up, and no intraoperative or postoperative complications (infection, graft failure, or re-tear) were observed. VAS pain improved from a median of 4.0 (IQR = 3.0-5.0) preoperatively to 0.0 (0.0-0.0) at six months (Friedman χ²(3) = 298.7, p < 0.001; Wilcoxon vs. preoperatively p < 0.001, r = 0.87). The Lysholm score improved from 66.0 (60.0-73.0) to 94.0 (94.0-94.0) (Friedman χ²(3) = 292.3, p < 0.001; r = 0.86 at six months). The IKDC subjective score transiently declined at six weeks (median = 42.5 vs. 44.8 preoperatively, p < 0.001) before improving to 77.0 (72.4-81.6) at six months (Friedman χ²(3) = 278.1, p < 0.001; r = 0.87). All pairwise comparisons against baseline were significant except the Lysholm score at six weeks (p ≈ 0.05).

In this single-arm prospective cohort, arthroscopic ACLR with concurrent meniscal repair was associated with significant improvements in pain and patient-reported knee function over six months, with no observed complications. Because the study lacked a comparison group, these findings demonstrate favourable within-cohort outcomes and suggest that incorporating meniscal repair into ACLR does not appear to compromise short-term recovery; they cannot establish the efficacy or comparative effectiveness of the intervention. Further comparative and longitudinal studies are warranted.