Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2018

01-04-2018 | Knee

Concomitant meniscal injury in anterior cruciate ligament reconstruction does not lead to poorer short-term post-operative outcomes

Authors: Amritpal Singh, Desmond Thiam Wei, Cheryl Tan Pei Lin, Shen Liang, Saumitra Goyal, Kimberly-Anne Tan, Brian Zhaojie Chin, Lingaraj Krishna

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2018

Login to get access

Abstract

Purpose

The main objective was to compare post-operative outcomes in patients undergoing anterior cruciate ligament (ACL) reconstruction both with and without concomitant meniscus injury at a mean follow-up of 3.5 years. The secondary objective was to study the effect of different meniscal injury sites and treatment modalities on post-operative outcomes (PROS).

Methods

This is a retrospective analysis of a prospectively maintained database of patients undergoing ACL reconstruction at our tertiary institution between 2009 and 2012. Age, sex, graft type, graft fixation modality, location of meniscal tear and treatment (meniscal repair or meniscectomy) were recorded in the database. PROS used included the Tegner activity scale and the Lysholm score.

Results

There were no significant differences between patients with or without meniscal injury in terms of age, BMI or preoperative PROS. There was no significant difference in the post-operative outcome scores between patients with or without meniscal injury at a mean follow-up of 3.5 years. Regardless of the location of meniscal injury, the post-operative scores improved as compared to preoperative scores.

Conclusion

Concomitant meniscal injury in cases of ACL reconstruction is not associated with poorer short-term post-operative PROS (mean follow-up time: 3.5 years). These findings may influence management decisions and help in preoperative counselling.

Level of evidence

IV.
Literature
1.
go back to reference Ahn JH, Park JS, Lee YS, Cho YJ (2007) Femoral bioabsorbable cross-pin fixation in anterior cruciate ligament reconstruction. Arthroscopy 23:1093–1099CrossRefPubMed Ahn JH, Park JS, Lee YS, Cho YJ (2007) Femoral bioabsorbable cross-pin fixation in anterior cruciate ligament reconstruction. Arthroscopy 23:1093–1099CrossRefPubMed
2.
go back to reference Anderson AF, Irrgang JJ, Dunn W, Beaufils P, Cohen M, Cole BJ et al (2011) Interobserver reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med 39:926–932CrossRefPubMed Anderson AF, Irrgang JJ, Dunn W, Beaufils P, Cohen M, Cole BJ et al (2011) Interobserver reliability of the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification of meniscal tears. Am J Sports Med 39:926–932CrossRefPubMed
3.
go back to reference Barenius B, Forssblad M, Engstrom B, Eriksson K (2013) Functional recovery after anterior cruciate ligament reconstruction, a study of health-related quality of life based on the Swedish National Knee Ligament Register. Knee Surg Sports Traumatol Arthrosc 21:914–927CrossRefPubMed Barenius B, Forssblad M, Engstrom B, Eriksson K (2013) Functional recovery after anterior cruciate ligament reconstruction, a study of health-related quality of life based on the Swedish National Knee Ligament Register. Knee Surg Sports Traumatol Arthrosc 21:914–927CrossRefPubMed
4.
go back to reference Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 88:698–705PubMed Briggs KK, Kocher MS, Rodkey WG, Steadman JR (2006) Reliability, validity, and responsiveness of the Lysholm knee score and Tegner activity scale for patients with meniscal injury of the knee. J Bone Joint Surg Am 88:698–705PubMed
5.
go back to reference Fetzer GB, Spindler KP, Amendola A, Andrish JT, Bergfeld JA, Dunn WR et al (2009) Potential market for new meniscus repair strategies: evaluation of the MOON cohort. J Knee Surg 22:180–186CrossRefPubMedPubMedCentral Fetzer GB, Spindler KP, Amendola A, Andrish JT, Bergfeld JA, Dunn WR et al (2009) Potential market for new meniscus repair strategies: evaluation of the MOON cohort. J Knee Surg 22:180–186CrossRefPubMedPubMedCentral
6.
go back to reference Fitzgibbons RE, Shelbourne KD (1995) “Aggressive” nontreatment of lateral meniscal tears seen during anterior cruciate ligament reconstruction. Am J Sports Med 23:156–159CrossRefPubMed Fitzgibbons RE, Shelbourne KD (1995) “Aggressive” nontreatment of lateral meniscal tears seen during anterior cruciate ligament reconstruction. Am J Sports Med 23:156–159CrossRefPubMed
7.
go back to reference Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE et al (2000) Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 8:141–150CrossRefPubMed Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE et al (2000) Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 8:141–150CrossRefPubMed
8.
go back to reference Hovinga KR, Lerner AL (2009) Anatomic variations between Japanese and Caucasian populations in the healthy young adult knee joint. J Orthop Res 27:1191–1196CrossRefPubMed Hovinga KR, Lerner AL (2009) Anatomic variations between Japanese and Caucasian populations in the healthy young adult knee joint. J Orthop Res 27:1191–1196CrossRefPubMed
9.
go back to reference Janssen RP, du Mee AW, van Valkenburg J, Sala HA, Tseng CM (2013) Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors. Knee Surg Sports Traumatol Arthrosc 21:1977–1988CrossRefPubMed Janssen RP, du Mee AW, van Valkenburg J, Sala HA, Tseng CM (2013) Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors. Knee Surg Sports Traumatol Arthrosc 21:1977–1988CrossRefPubMed
10.
go back to reference Jarvela T, Kannus P, Jarvinen M (2001) Anterior cruciate ligament reconstruction in patients with or without accompanying injuries: a re-examination of subjects 5 to 9 years after reconstruction. Arthroscopy 17:818–825CrossRefPubMed Jarvela T, Kannus P, Jarvinen M (2001) Anterior cruciate ligament reconstruction in patients with or without accompanying injuries: a re-examination of subjects 5 to 9 years after reconstruction. Arthroscopy 17:818–825CrossRefPubMed
11.
go back to reference Kartus JT, Russell VJ, Salmon LJ, Magnusson LC, Brandsson S, Pehrsson NG et al (2002) Concomitant partial meniscectomy worsens outcome after arthroscopic anterior cruciate ligament reconstruction. Acta Orthop Scand 73:179–185CrossRefPubMed Kartus JT, Russell VJ, Salmon LJ, Magnusson LC, Brandsson S, Pehrsson NG et al (2002) Concomitant partial meniscectomy worsens outcome after arthroscopic anterior cruciate ligament reconstruction. Acta Orthop Scand 73:179–185CrossRefPubMed
12.
go back to reference LaPrade CM, Dornan GJ, Granan LP, LaPrade RF, Engebretsen L (2015) Outcomes after anterior cruciate ligament reconstruction using the Norwegian Knee Ligament Registry of 4691 Patients: how does meniscal repair or resection affect short-term outcomes? Am J Sports Med 43:1591–1597CrossRefPubMed LaPrade CM, Dornan GJ, Granan LP, LaPrade RF, Engebretsen L (2015) Outcomes after anterior cruciate ligament reconstruction using the Norwegian Knee Ligament Registry of 4691 Patients: how does meniscal repair or resection affect short-term outcomes? Am J Sports Med 43:1591–1597CrossRefPubMed
13.
go back to reference Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154CrossRefPubMed Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154CrossRefPubMed
14.
go back to reference Melton JT, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP (2011) Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 19:1729–1734CrossRefPubMed Melton JT, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP (2011) Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 19:1729–1734CrossRefPubMed
15.
go back to reference Noyes FR, Barber-Westin SD (2002) Arthroscopic repair of meniscal tears extending into the avascular zone in patients younger than twenty years of age. Am J Sports Med 30:589–600CrossRefPubMed Noyes FR, Barber-Westin SD (2002) Arthroscopic repair of meniscal tears extending into the avascular zone in patients younger than twenty years of age. Am J Sports Med 30:589–600CrossRefPubMed
16.
go back to reference Paradowski PT, Keska R, Witonski D (2014) Does concomitant meniscectomy affect medium-term outcome of anterior cruciate ligament reconstruction? A preliminary report. Arch Med Sci 10:992–998CrossRefPubMedPubMedCentral Paradowski PT, Keska R, Witonski D (2014) Does concomitant meniscectomy affect medium-term outcome of anterior cruciate ligament reconstruction? A preliminary report. Arch Med Sci 10:992–998CrossRefPubMedPubMedCentral
17.
go back to reference Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP (1995) Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 23:240–244CrossRefPubMed Rangger C, Klestil T, Gloetzer W, Kemmler G, Benedetto KP (1995) Osteoarthritis after arthroscopic partial meniscectomy. Am J Sports Med 23:240–244CrossRefPubMed
18.
go back to reference Robb C, Kempshall P, Getgood A, Standell H, Sprowson A, Thompson P et al (2015) Meniscal integrity predicts laxity of anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23:3683–3690CrossRefPubMed Robb C, Kempshall P, Getgood A, Standell H, Sprowson A, Thompson P et al (2015) Meniscal integrity predicts laxity of anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23:3683–3690CrossRefPubMed
19.
go back to reference Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96CrossRefPubMed Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96CrossRefPubMed
20.
go back to reference Rotterud JH, Sivertsen EA, Forssblad M, Engebretsen L, Aroen A (2013) Effect of meniscal and focal cartilage lesions on patient-reported outcome after anterior cruciate ligament reconstruction: a nationwide cohort study from Norway and Sweden of 8476 patients with 2-year follow-up. Am J Sports Med 41:535–543CrossRefPubMed Rotterud JH, Sivertsen EA, Forssblad M, Engebretsen L, Aroen A (2013) Effect of meniscal and focal cartilage lesions on patient-reported outcome after anterior cruciate ligament reconstruction: a nationwide cohort study from Norway and Sweden of 8476 patients with 2-year follow-up. Am J Sports Med 41:535–543CrossRefPubMed
21.
go back to reference Salmon LJ, Russell VJ, Refshauge K, Kader D, Connolly C, Linklater J et al (2006) Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: minimum 13-year review. Am J Sports Med 34:721–732CrossRefPubMed Salmon LJ, Russell VJ, Refshauge K, Kader D, Connolly C, Linklater J et al (2006) Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: minimum 13-year review. Am J Sports Med 34:721–732CrossRefPubMed
22.
go back to reference Shelbourne KD, Gray T (2009) Minimum 10-year results after anterior cruciate ligament reconstruction: how the loss of normal knee motion compounds other factors related to the development of osteoarthritis after surgery. Am J Sports Med 37:471–480CrossRefPubMed Shelbourne KD, Gray T (2009) Minimum 10-year results after anterior cruciate ligament reconstruction: how the loss of normal knee motion compounds other factors related to the development of osteoarthritis after surgery. Am J Sports Med 37:471–480CrossRefPubMed
23.
go back to reference Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49 Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
Metadata
Title
Concomitant meniscal injury in anterior cruciate ligament reconstruction does not lead to poorer short-term post-operative outcomes
Authors
Amritpal Singh
Desmond Thiam Wei
Cheryl Tan Pei Lin
Shen Liang
Saumitra Goyal
Kimberly-Anne Tan
Brian Zhaojie Chin
Lingaraj Krishna
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4635-2

Other articles of this Issue 4/2018

Knee Surgery, Sports Traumatology, Arthroscopy 4/2018 Go to the issue