Meniscal repair may be effective in revision ACL reconstruction
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Key takeaways:
- Results showed meniscal repair failure rate was 16% at 6-year follow-up.
- Meniscal repair failure was more common in medial-sided repairs vs. lateral-sided repairs.
SAN FRANCISCO — Meniscal repair may be effective in revision ACL reconstruction, according to results presented here.
“Meniscal repair in the revision ACL reconstruction setting is indeed a worthwhile endeavor, with an 84% success rate over 6 years,” Jacob A. Fox, MD, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Fox and colleagues performed a longitudinal prospective cohort study that evaluated the 6-year follow-up of 221 patients (238 meniscal repairs) from the Multicenter ACL-Revision Study (MARS) cohort who underwent concurrent revision ACL reconstruction and meniscal repair.
Outcomes included meniscal repair failure and patient-reported outcome measures, including KOOS scores, IKDC scores and Marx activity scores.
Overall, Fox said the meniscal failure rate was 16% at 6-year follow-up, which was an increase from the previously reported 8.6% failure rate at 2-year follow-up from the MARS cohort.
“This was expected, as the literature shows that failure rates increase with prolonged follow-up,” Fox said.
He added that 28 of the 31 meniscal failures were medial-sided repairs. In addition, the medial failure rate was 20%, while the lateral failure rate was 5.7%.
Fox said that lower BMI was associated with increased failure risk independent of activity level.
Meniscal repair success rate was not significantly associated with tear location, tear severity, tear type, ACL graft choice or repair method, according to Fox.
In terms of patient-reported outcome measures at 6-year follow-up, Fox said that the only clinically significant difference was in the KOOS quality of life subset, which showed increased scores in patients with successful repairs.
“Our finding of increased medial-sided repair failure is consistent with primary ACL reconstruction and 2-year MARS data as well,” Fox said. “This could be explained by the fact that the medial meniscus is more tightly engaged to the plateau, meaning higher medial-sided biomechanical forces.”
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Fox JA, et al. Meniscal repair in the setting of revision anterior cruciate ligament reconstruction: 6-year follow-up results from the MARS cohort. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
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