Partial Meniscectomy Increases Risk of Anterior Cruciate Ligament Revision Surgery Compared With Meniscus Repair in Patients With Concurrent Meniscus and Anterior Cruciate Ligament Tears After Anterior Cruciate Ligament Reconstruction.

Abstract

To compare the rates of revision anterior cruciate ligament (ACL) reconstruction, meniscal reoperation, and total knee arthroplasty associated with partial meniscectomy and meniscal repair performed at the time of index ACL reconstruction in patients with concurrent meniscus and ACL tears. The TriNetX database was queried for patients undergoing ACL reconstruction after January 1, 2000, with minimum 1-year clinical follow up. Inclusion criteria for this study were patients who had partial meniscectomy, meniscal repair, or isolated ACL reconstruction without meniscus injury. Statistical analyses were performed using Python with significance thresholds of P < .05. A total of 39,126 patients were followed for an average of 5.02 years. Patients undergoing meniscal repair were less likely to experience revision ACL reconstruction compared with those undergoing partial meniscectomy (relative risk [RR] 0.78, confidence interval [CI] 0.71-0.85, P < .001). Meniscus reoperation occurred significantly more in patients undergoing meniscal repair (RR 1.26, CI 1.17-1.35, P < .001) than those undergoing partial meniscectomy. Regarding total knee arthroplasty, partial meniscectomy carried a more than 6-fold increased risk compared with isolated ACL reconstruction (RR 6.4, CI 2.49-16.42, P < .001). In patients with ACL injury, ACL reconstruction, and concurrent meniscus tear, those patients treated with meniscus repair were less likely to undergo revision surgery. In these patients, medial meniscal injuries were associated with ACL revision than lateral meniscal injury regardless of the method of treatment. When meniscus repair is performed, this is associated with lower rate of future total knee arthroplasty. Level III, retrospective cohort study.