K. Plancher (New York, US)
Plancher Orthopaedics & Sports Medicine Department of Orthopaedic SurgeryPresenter Of 1 Presentation
18.1.10 - Repairing Lateral Meniscus Tears With ACL Reconstruction Ensures Low Rate of Symptomatic OA Compared to Meniscectomy at 11-Year Follow Up
Abstract
Purpose
Systematic reviews have suggested that meniscal pathology, which occurs in up to 60% of patients with ACL injury, increases the risk of osteoarthritis following anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to determine the incidence of osteoarthritis following lateral meniscus repair versus partial lateral meniscectomy in patients with ACLR.
Methods and Materials
All patients who underwent primary autograft or allograft bone-patellar tendon-bone (BPTB) transtibial ACLR by a single surgeon (1999-2018) were identified. Revision ACLR, multi-ligamentous reconstructions, and patients with less than 2-year imaging follow-up were excluded. Patients with lateral meniscus pathology at the time of ACLR were identified and treatment was extracted. Osteoarthritis was defined as Kellgren-Lawrence (KL) grade III-IV on plain radiographs at follow-up.
Results
A consecutive series of 107 patients (55 males, 52 females; age 35.9 ± 11.9 years) with BPTB ACLR were included (average follow-up 11.0 ± 5.1 [range 3-21 years]). The prevalence of lateral meniscus tears was 59.8% (64/107). 27.5% of patients (14/51) that underwent partial lateral meniscectomy developed lateral osteoarthritis compared to 0% of patients (0/13) that underwent lateral meniscal repair. Patients that underwent lateral meniscectomy had a 27.5% chance of developing lateral compartment knee osteoarthritis; a 6.2 times greater risk compared to patients that underwent lateral meniscus repair. Tear morphology, tear location, and tear zone were not found to be associated with the development of lateral osteoarthritis.
Conclusion
Following lateral meniscectomy, patients with lateral meniscal tears have an approximately 30% chance of developing grade 3-4 symptomatic osteoarthritis in the lateral compartment at 11-year follow-up. In contradistinction, successful lateral meniscus repairs substantially decrease the risk of developing osteoarthritis in the lateral compartment. We believe lateral meniscal repair is essential for lateral meniscus tears at the time ACL reconstruction to help avoid osteoarthritis development.