Incidence and Healing Rates of Meniscal Tears in Patients Undergoing Repair During the First Stage of 2-Stage Revision Anterior Cruciate Ligament Reconstruction.

Abstract

Meniscal tears, including tears at the root attachment, have been associated with tears of the anterior cruciate ligament (ACL) in both primary and revision settings. However, there is a paucity of literature reporting the healing rates of meniscal repair during 2-stage revision ACL reconstruction (ACLR). To evaluate the healing rates of meniscal repairs performed during 2-stage revision ACLR in ACL-deficient knees and to report the incidence of meniscus root tears in patients undergoing primary ACLR as compared with revision ACLR. Case series; Level of evidence, 4. Patients who underwent primary and revision ACLR by a single surgeon were retrospectively identified. Revision ACLRs were grouped according to 1- or 2-stage ACLR. Meniscal tears were grouped according to laterality (medial, lateral) and location of tears. Meniscal repair technique was recorded, including transtibial or inside-out. Meniscal repair healing was assessed via second-look arthroscopy at the time of second-stage revision ACLR. There were 1168 patients identified who underwent ACLR: 851 primary and 317 revision procedures. Sixty-four patients underwent meniscal repair during first-stage bone grafting in ACL-deficient knees, with an overall healing rate of 86%. The healing rates were 82.3% for meniscus root tears via the transtibial repair technique and 92.4% for meniscal peripheral tears via the inside-out repair technique. Meniscus root tears had overall incidences of 15.5% and 26.2% in primary and revision ACLRs, respectively. The incidence of lateral meniscus posterior root tears was approximately 4 times higher than of medial meniscus posterior root tears in both primary (12.2% vs 3.2%) and revision (20.5% vs 5.6%) ACLRs. A high incidence of meniscus root tears was found in patients undergoing revision ACLRs as compared with primary ACLRs. Meniscal repairs have a high rate of healing and success when performed during the first stage of revision ACLR in ACL-deficient knees.