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April 25, 2023
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Prior isolated meniscus surgery increases risk of future ipsilateral ACL reconstruction

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Key takeaways:

  • Prior meniscus surgery is a potential risk factor of subsequent ipsilateral ACL reconstruction.
  • Patients with bucket-handle meniscal tears are at the highest risk for future ACL reconstruction.

LAS VEGAS — According to presented results, patients with isolated bucket-handle meniscal tears are more likely to require future ipsilateral ACL reconstruction compared with other meniscal injuries.

“A lot of the research looking at the relationship between [the] ACL and meniscus has been more so: After you have an ACL reconstruction, what is risk of getting a meniscus tear?” William McLaughlin, MD, said in his presentation at the American Orthopaedic Society for Sports Medicine Specialty Day during the American Academy of Orthopaedic Surgeons Annual Meeting. “So, our question was: How about the other way around? How about if you had a meniscus tear first, what is your risk of getting ACL reconstruction?” he added.

ACL Sports Injury
Prior meniscus surgery may be a potential risk factor of subsequent ipsilateral ACL reconstruction. Image: Adobe Stock

McLaughlin and colleagues from Yale New Haven Health analyzed 106,185 isolated meniscus tears in patients aged 10 to 40 years who underwent meniscus repair or meniscectomy from 2015 to 2020. They recorded ipsilateral subsequent reoperations for ACL reconstruction (ACLR) up to 5 years after meniscus surgery.

William McLaughlin
William McLaughlin

The population incidence for patients who had a first-time ACLR was 0.2%, according to the study. They found patients who underwent surgery for an isolated bucket-handle (BH) meniscus tear had a significantly increased risk for ACLR within 5 years relative to the population incidence of ACLR (OR = 8.54).

Researchers also noted patients who had medial BH tears (OR = 10.87) and patients with non-BH tears (OR = 3.66) had a significantly increased risk for ACLR within 5 years. Patients with medial BH tears who underwent meniscal had the highest odds of undergoing future ACLR (OR = 17.53), according to the abstract.

“Having prior isolated meniscus surgery repair or meniscectomy is a potential risk factor for subsequent ipsilateral ACL reconstruction,” McLaughlin concluded.