A prospective clinical evaluation of meniscal repair, with or without concomitant anterior cruciate ligament reconstruction, in paediatric patients.

Abstract

Studies reporting paediatric meniscal repair outcomes are limited, often retrospective and lacking objective outcomes. This study sought to determine clinical outcomes, return to sport (RTS), meniscal healing and re-injury rates in paediatric patients undergoing meniscal repair, with or without anterior cruciate ligament reconstruction (ACLR). Overall, 32 paediatric patients (mean age 13.8 years) undergoing meniscal repair were recruited, in isolation (n = 14) or with ACLR (n = 18). Outcomes to 24 months included patient-reported outcome measures (PROMs), RTS, isokinetic strength and a 5-hop battery. Limb Symmetry Indices (LSIs) were calculated. Re-injuries and re-operations were presented. Magnetic resonance imaging (MRI) was undertaken to assess healing. All PROMs, quadriceps strength and hop test LSIs improved (p < 0.05). While those undergoing isolated meniscal repair (versus those with ACLR) demonstrated higher LSIs for the triple (p = 0.023) and triple crossover (p = 0.019) hop tests at 6 months, and the medial hop test at 6 (p = 0.042) and 12 (p = 0.019) months, no other differences existed. Mean LSIs for all strength and hop tests were ≥90 % at 12 and 24 months. Of the 96.4 % of patients participating in Noyes Level 1 or 2 pivoting sports pre-injury, 89.3 % were by 24 months. One isolated repair patient encountered a re-injury at 18 months, while one combined ACLR and meniscal repair patient suffered an ACL re-tear at 14 months. Complete or near-full healing was observed on MRI in 68 % of repairs. Subjective and physical performance scores improved following meniscal repair, either in isolation or concomitantly with ACLR, with high levels of RTS.