Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction

• Published in: BMC musculoskeletal disorders 2023-09, Vol.24 (1), p.1-737, Article 737
• Main Authors: Kaarre, Janina, Herman, Zachary J, Persson, Fabian, Wållgren, Jonas Olsson, Alentorn-Geli, Eduard, Senorski, Eric Hamrin, Musahl, Volker, Samuelsson, Kristian
• Format: Article
• Language: English
• Subjects: Activities of daily living; Anterior cruciate ligament; Anterior Cruciate Ligament Injuries; Arthritis; Arthroplasty; Clinical Medicine; Cohort analysis; complications; diagnosis; Humans; Injuries; Joint and ligament injuries; Klinisk medicin; Knee; Knee Joint; KOOS; Lateral meniscal repair; Lateral meniscal resection; Meniscectomy; Menisci; Meniscus; Meniscus (Anatomy); Musculoskeletal diseases; Orthopedics; Ortopedi; Osteoarthritis; Outdoor activities; Patients; Physiological aspects; Population studies; Postoperative period; Quality of life; Questionnaires; Replacement; Surgeons; Surgery; Tibial; Variables
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06867-z

Background Concomitant lateral meniscal (LM) injuries are common in acute anterior cruciate ligament (ACL) ruptures. However, the effect of addressing these injuries with various treatment methods during primary ACL reconstruction (ACLR) on patient-reported outcomes (PROs) is unknown. Therefore, the purpose of this study was to compare postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) at 2-, 5-, and 10-years after isolated primary ACLR to primary ACLR with various treatment methods to address concomitant LM injury. Methods This study was based on data from the Swedish National Knee Ligament Registry. Patients [greater than or equal to] 15 years with data on postoperative KOOS who underwent primary ACLR between the years 2005 and 2018 were included in this study. The study population was divided into five groups: 1) Isolated ACLR, 2) ACLR + LM repair, 3) ACLR + LM resection, 4) ACLR + LM injury left in situ, and 5) ACLR + LM repair + LM resection. Patients with concomitant medial meniscal or other surgically treated ligament injuries were excluded. Results Of 31,819 included patients, 24% had LM injury. After post hoc comparisons, significantly lower scores were found for the KOOS Symptoms subscale in ACLR + LM repair group compared to isolated ACLR (76.0 vs 78.3, p = 0.0097) and ACLR + LM injury left in situ groups (76.0 vs 78.3, p = 0.041) at 2-year follow-up. However, at 10-year follow-up, no differences were found between ACLR + LM repair and isolated ACLR, but ACLR + LM resection resulted in significantly lower KOOS Symptoms scores compared to isolated ACLR (80.4 vs 82.3, p = 0.041). Conclusion The results of this study suggest that LM injury during ACLR is associated with lower KOOS scores, particularly in the Symptoms subscale, at short- and long-term follow-up. However, this finding falls below minimal clinical important difference and therefore may not be clinically relevant. Level of Evidence III. Keywords: Lateral meniscal repair, Lateral meniscal resection, KOOS