Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: Results From the MARS Cohort

MARS Group

doi:10.1177/0363546520948850

Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: Results From the MARS Cohort

MARS Group

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Meniscal preservation has been demonstrated to contribute to long-term knee health. This has been a successful intervention in patients with isolated tears and tears associated with anterior cruciate ligament (ACL) reconstruction. However, the results of meniscal repair in the setting of revision ACL reconstruction have not been documented. Purpose: To examine the prevalence and 2-year operative success rate of meniscal repairs in the revision ACL setting. Study Design: Case-control study; Level of evidence, 3. Methods: All cases of revision ACL reconstruction with concomitant meniscal repair from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by phone and email to determine whether any subsequent surgery had occurred to either knee since the initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify the pathologic condition and subsequent treatment. Results: In total, 218 patients (18%) from 1205 revision ACL reconstructions underwent concurrent meniscal repairs. There were 235 repairs performed: 153 medial, 48 lateral, and 17 medial and lateral. The majority of these repairs (n = 178; 76%) were performed with all-inside techniques. Two-year surgical follow-up was obtained on 90% (197/218) of the cohort. Overall, the meniscal repair failure rate was 8.6% (17/197) at 2 years. Of the 17 failures, 15 were medial (13 all-inside, 2 inside-out) and 2 were lateral (both all-inside). Four medial failures were treated in conjunction with a subsequent repeat revision ACL reconstruction. Conclusion: Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up. Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.

Original language	English
Journal	American Journal of Sports Medicine
DOIs	https://doi.org/10.1177/0363546520948850
State	Accepted/In press - 2020

Keywords

ACL reconstruction
failure
meniscus
outcomes
repair
revision

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@article{c61d1fb831e041af9104fcf9e08334e6,

title = "Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: Results From the MARS Cohort",

abstract = "Background: Meniscal preservation has been demonstrated to contribute to long-term knee health. This has been a successful intervention in patients with isolated tears and tears associated with anterior cruciate ligament (ACL) reconstruction. However, the results of meniscal repair in the setting of revision ACL reconstruction have not been documented. Purpose: To examine the prevalence and 2-year operative success rate of meniscal repairs in the revision ACL setting. Study Design: Case-control study; Level of evidence, 3. Methods: All cases of revision ACL reconstruction with concomitant meniscal repair from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by phone and email to determine whether any subsequent surgery had occurred to either knee since the initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify the pathologic condition and subsequent treatment. Results: In total, 218 patients (18%) from 1205 revision ACL reconstructions underwent concurrent meniscal repairs. There were 235 repairs performed: 153 medial, 48 lateral, and 17 medial and lateral. The majority of these repairs (n = 178; 76%) were performed with all-inside techniques. Two-year surgical follow-up was obtained on 90% (197/218) of the cohort. Overall, the meniscal repair failure rate was 8.6% (17/197) at 2 years. Of the 17 failures, 15 were medial (13 all-inside, 2 inside-out) and 2 were lateral (both all-inside). Four medial failures were treated in conjunction with a subsequent repeat revision ACL reconstruction. Conclusion: Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up. Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.",

keywords = "ACL reconstruction, failure, meniscus, outcomes, repair, revision",

author = "{MARS Group} and Wright, {Rick W.} and Huston, {Laura J.} and Haas, {Amanda K.} and Nwosu, {Samuel K.} and Allen, {Christina R.} and Anderson, {Allen F.} and Cooper, {Daniel E.} and DeBerardino, {Thomas M.} and Dunn, {Warren R.} and Lantz, {Brett (Brick) A.} and Barton Mann and Spindler, {Kurt P.} and Stuart, {Michael J.} and Pennings, {Jacquelyn S.} and Albright, {John P.} and Annunziato Amendola and Andrish, {Jack T.} and Annunziata, {Christopher C.} and Arciero, {Robert A.} and Bach, {Bernard R.} and Baker, {Champ L.} and Bartolozzi, {Arthur R.} and Baumgarten, {Keith M.} and Bechler, {Jeffery R.} and Berg, {Jeffrey H.} and Bernas, {Geoffrey A.} and Brockmeier, {Stephen F.} and Brophy, {Robert H.} and Bush-Joseph, {Charles A.} and {Butler V}, {J. Brad} and Campbell, {John D.} and Carey, {James L.} and Carpenter, {James E.} and Cole, {Brian J.} and Cooper, {Jonathan M.} and Cox, {Charles L.} and Creighton, {R. Alexander} and Dahm, {Diane L.} and David, {Tal S.} and Flanigan, {David C.} and Frederick, {Robert W.} and Ganley, {Theodore J.} and Garofoli, {Elizabeth A.} and Gatt, {Charles J.} and Gecha, {Steven R.} and Giffin, {James Robert} and Hame, {Sharon L.} and Hannafin, {Jo A.} and Matava, {Matthew J.} and Smith, {Matthew V.}",

year = "2020",

doi = "10.1177/0363546520948850",

language = "English",

journal = "American Journal of Sports Medicine",

issn = "0363-5465",

}

TY - JOUR

T1 - Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction

T2 - Results From the MARS Cohort

AU - MARS Group

AU - Wright, Rick W.

AU - Huston, Laura J.

AU - Haas, Amanda K.

AU - Nwosu, Samuel K.

AU - Allen, Christina R.

AU - Anderson, Allen F.

AU - Cooper, Daniel E.

AU - DeBerardino, Thomas M.

AU - Dunn, Warren R.

AU - Lantz, Brett (Brick) A.

AU - Mann, Barton

AU - Spindler, Kurt P.

AU - Stuart, Michael J.

AU - Pennings, Jacquelyn S.

AU - Albright, John P.

AU - Amendola, Annunziato

AU - Andrish, Jack T.

AU - Annunziata, Christopher C.

AU - Arciero, Robert A.

AU - Bach, Bernard R.

AU - Baker, Champ L.

AU - Bartolozzi, Arthur R.

AU - Baumgarten, Keith M.

AU - Bechler, Jeffery R.

AU - Berg, Jeffrey H.

AU - Bernas, Geoffrey A.

AU - Brockmeier, Stephen F.

AU - Brophy, Robert H.

AU - Bush-Joseph, Charles A.

AU - Butler V, J. Brad

AU - Campbell, John D.

AU - Carey, James L.

AU - Carpenter, James E.

AU - Cole, Brian J.

AU - Cooper, Jonathan M.

AU - Cox, Charles L.

AU - Creighton, R. Alexander

AU - Dahm, Diane L.

AU - David, Tal S.

AU - Flanigan, David C.

AU - Frederick, Robert W.

AU - Ganley, Theodore J.

AU - Garofoli, Elizabeth A.

AU - Gatt, Charles J.

AU - Gecha, Steven R.

AU - Giffin, James Robert

AU - Hame, Sharon L.

AU - Hannafin, Jo A.

AU - Matava, Matthew J.

AU - Smith, Matthew V.

PY - 2020

Y1 - 2020

N2 - Background: Meniscal preservation has been demonstrated to contribute to long-term knee health. This has been a successful intervention in patients with isolated tears and tears associated with anterior cruciate ligament (ACL) reconstruction. However, the results of meniscal repair in the setting of revision ACL reconstruction have not been documented. Purpose: To examine the prevalence and 2-year operative success rate of meniscal repairs in the revision ACL setting. Study Design: Case-control study; Level of evidence, 3. Methods: All cases of revision ACL reconstruction with concomitant meniscal repair from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by phone and email to determine whether any subsequent surgery had occurred to either knee since the initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify the pathologic condition and subsequent treatment. Results: In total, 218 patients (18%) from 1205 revision ACL reconstructions underwent concurrent meniscal repairs. There were 235 repairs performed: 153 medial, 48 lateral, and 17 medial and lateral. The majority of these repairs (n = 178; 76%) were performed with all-inside techniques. Two-year surgical follow-up was obtained on 90% (197/218) of the cohort. Overall, the meniscal repair failure rate was 8.6% (17/197) at 2 years. Of the 17 failures, 15 were medial (13 all-inside, 2 inside-out) and 2 were lateral (both all-inside). Four medial failures were treated in conjunction with a subsequent repeat revision ACL reconstruction. Conclusion: Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up. Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.

AB - Background: Meniscal preservation has been demonstrated to contribute to long-term knee health. This has been a successful intervention in patients with isolated tears and tears associated with anterior cruciate ligament (ACL) reconstruction. However, the results of meniscal repair in the setting of revision ACL reconstruction have not been documented. Purpose: To examine the prevalence and 2-year operative success rate of meniscal repairs in the revision ACL setting. Study Design: Case-control study; Level of evidence, 3. Methods: All cases of revision ACL reconstruction with concomitant meniscal repair from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by phone and email to determine whether any subsequent surgery had occurred to either knee since the initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify the pathologic condition and subsequent treatment. Results: In total, 218 patients (18%) from 1205 revision ACL reconstructions underwent concurrent meniscal repairs. There were 235 repairs performed: 153 medial, 48 lateral, and 17 medial and lateral. The majority of these repairs (n = 178; 76%) were performed with all-inside techniques. Two-year surgical follow-up was obtained on 90% (197/218) of the cohort. Overall, the meniscal repair failure rate was 8.6% (17/197) at 2 years. Of the 17 failures, 15 were medial (13 all-inside, 2 inside-out) and 2 were lateral (both all-inside). Four medial failures were treated in conjunction with a subsequent repeat revision ACL reconstruction. Conclusion: Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up. Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.

KW - ACL reconstruction

KW - failure

KW - meniscus

KW - outcomes

KW - repair

KW - revision

UR - http://www.scopus.com/inward/record.url?scp=85089602609&partnerID=8YFLogxK

U2 - 10.1177/0363546520948850

DO - 10.1177/0363546520948850

M3 - Article

C2 - 32822238

AN - SCOPUS:85089602609

JO - American Journal of Sports Medicine

JF - American Journal of Sports Medicine

SN - 0363-5465

ER -