Meniscal problems in the ACL deficient knee: What every ACL surgeon must be able to do

Meniscal tears are common concomitant injuries seen in up to 65% of anterior cruciate ligament (ACL) deficient knees. The goal of ACL reconstruction (ACL-R) is to restore mechanical stability to the knee and to prevent further damage to the menisci, which act as secondary knee stabilizers for both a...

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Bibliographic Details
Published in:Operative techniques in sports medicine 2021-06, Vol.29 (2), p.150832, Article 150832
Main Authors: Wagala, Nyaluma N., Tisherman, Robert T., Lucidi, Gian Andrea, Eads, Ryan, Musahl, Volker
Format: Article
Language:English
Subjects:
ACL
Anterior cruciate ligament
Biomechanics
Decision making
Joint and ligament injuries
Kinematics
Knee
Ligaments
Magnetic resonance imaging
meniscectomy
meniscus
meniscus repair
Patients
Sports injuries
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Summary:Meniscal tears are common concomitant injuries seen in up to 65% of anterior cruciate ligament (ACL) deficient knees. The goal of ACL reconstruction (ACL-R) is to restore mechanical stability to the knee and to prevent further damage to the menisci, which act as secondary knee stabilizers for both anterior-posterior translation and rotational laxity. Delayed ACL-R and chronic ACL insufficiency have been associated with secondary meniscal tears that are more likely to be complex tears. Excluding graft failure, another common cause of reoperation in ACL reconstructed knees is meniscal surgery. Therefore, addressing meniscal tears at time of primary ACL-R is important to restore joint mechanics, protect the ACL graft for successful healing, and prevent long-term osteoarthritis. Current management options include leaving tears in-situ, meniscectomy, or meniscus repair. However, inconsistent findings have identified the need for well-defined treatment recommendations. Surgical decision making is reliant upon multiple factors such as adequate understanding of meniscal anatomy, biomechanics, tear pattern, and patient factors. This review focuses on the impact of meniscus injuries in ACL deficient knees and addresses current surgical indications and outcomes.
ISSN:1060-1872
1557-9794
DOI:10.1016/j.otsm.2021.150832