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Higher reoperation rate of the medial meniscus tears than lateral meniscus tears treated with repair or left in situ concurrent to anterior cruciate ligament reconstruction
Author(s):
Bae J. (South Korea (ROK))
,
Bae J. (South Korea (ROK))
Affiliations:
Kim S.
,
Kim S.
Affiliations:
Jang K.
,
Jang K.
Affiliations:
Kim J.
,
Kim J.
Affiliations:
Kim S.
,
Kim S.
Affiliations:
Choi W.
,
Choi W.
Affiliations:
Lim H.
Lim H.
Affiliations:
ESSKA Academy. Bae J. May 9, 2018; 209494; P07-1491 Topic: Knee
Assoc. Prof. Ji-Hoon Bae
Assoc. Prof. Ji-Hoon Bae
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Abstract
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Objectives: The purpose of this study was to compare the biologic healing using a second-look arthroscopy between medial and lateral meniscus tears, which were treated with repair or left in situ at the time of anterior cruciate ligament reconstruction (ACLR). Based on the previous studies, we hypothesized that the healing of lateral meniscus tears would be superior to the medial meniscus tears.

Methods: We retrospectively reviewed the 256 patients who underwent second-look arthroscopy after primary single bundle ACLR since June 2005. The healing of meniscus tear following repair or left in situ was evaluated by second look arthroscopy. The meniscus healing was classified using the modified criteria of Henning et al: (1) healed; full thickness apposition of the original tear with no more than 10% of the original tear remaining. (2) partially healed; at least 50% of the original tear was healed and was stable when probed, (3) failed; more than 50% of the original tear was present or if unstable meniscus fragments required additional repairs or resection. Healed and partially healed were designated as success healing. Healing rate and incidence of reoperation were compared between medial and lateral meniscus tears. Independent t-test was used to compare continuous variables and a chi-square test was used to compare the categorical variables between medial meniscus and lateral meniscus. Statistical significance was defined when the p-value was < 0.05.

Results: 227 patients met the inclusion and exclusion criteria. Of these, there were 148 meniscus tears in 121 patients at index ACLR. The cohort consisted of 62 medial meniscus tears only, 38 lateral meniscus tears only, and 24 bilateral meniscus tears. At second look arthroscopy, the rate of "success healing" after meniscus repairs was 80% for medial meniscus tears and 91% for lateral meniscus tears. "Success healing" rate after left in situ was 86% for medial meniscus tears and 80% for lateral meniscus tears. Overall success healing rate following repair or left in situ was 81% for medial meniscus tears and 88% for lateral meniscus tears. No significant differences of demographic variables were found between medial and lateral meniscus tears. The meniscus reoperation rate was 9% for lateral meniscus tears and 19% for medial meniscus tears treated with repairs or left in situ.

Conclusions: The present study confirms that higher rate of healing after repair was observed in the lateral meniscus compared to medial meniscus by second-look arthroscopic evaluation. Reoperation was higher for medial meniscus tears due to failed healing.

Keywords:
Anterior cruciate ligament, meniscus, second look, arthroscopy, repair, reconstruction
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