Issue: April 2019
March 14, 2019
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Meniscal repair with concomitant ACL reconstruction yielded high success rate in pediatric patients

Issue: April 2019
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Adam J. Tagliero

LAS VEGAS — Pediatric and adolescent patients who underwent meniscal repair with concomitant ACL reconstruction experienced a high overall clinical success rate at long-term follow-up, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

Adam J. Tagliero , MD, and colleagues collected failure rate information, clinical exam data and patient-reported outcomes for 47 patients aged 18 years or younger who underwent meniscal repair with concomitant ACL reconstruction. Patients had a mean follow-up of 16.6 years, according to Tagliero.

“Overall, 13 of our 47 patients had failed at latest available follow-up,” Tagliero said in his presentation here. “The mean time to failure was 3.8 years, and failure was strictly defined as a need for additional meniscal surgery at the repair site.”

However, Tagliero noted 10 of the 13 failures occurred by midterm follow-up and the remaining three failures occurred in the interim. He added 10 patients failed due to meniscal reinjury and three patients failed with both meniscal and ACL reinjury.

“Nine of those patients underwent subsequent meniscectomy, two underwent a meniscectomy revision and ACL reconstruction, one underwent a meniscus repair and revision ACL reconstruction and one underwent meniscus repair that ultimately did require a subsequent meniscectomy,” Tagliero said.

He noted improvements in IKDC scores from 47.9 preoperatively to 87.7 postoperatively and Tegner activity scores from a mean of 1.9 preoperatively to 6.3 postoperatively. At long-term follow-up, IKDC scores did not clinically or statistically decline from midterm outcomes, according to Tagliero.

“Hypothesis testing showed no significant difference in the mean improvements of the IKDC scores between our female and male patients,” Tagliero said. “Similarly, an analysis of variance showed no significant difference in the mean improvement of IKDC scores between simple, bucket handle and complex tear types.” – by Casey Tingle

Reference:

Tagliero AJ, et al. Abstract 711. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 12-15, 2019; Las Vegas.

Disclosure: Tagliero reports no relevant financial disclosures.