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Delayed or neglected meniscus tear repair and meniscectomy in addition to ACL reconstruction have similar clinical outcome

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare the clinical outcomes of meniscus repair and meniscus resection with concurrent anterior cruciate ligament (ACL) reconstruction in patients with ACL rupture and neglected or delayed medial meniscus tears.

Methods

Thirty patients with ACL ruptures and unstable vertical longitudinal medial meniscus tears were included. Patients were divided into two groups. Group I included 15 patients who underwent meniscal repair and Group II included 15 patients who underwent meniscectomy. The knee range of motion, McMurray test, Lachman test, pivot shift test, Lysholm Knee Scoring Scale, International Knee Documentation Committee (IKDC) Questionnaire, Hospital for Special Surgery (HSS) Knee score, and Tegner activity (TA) scale were used to assess all patients.

Results

The median follow-up time was 3.6 (0.5–6.5) years. Median age was 28 (16–36) years. Fourteen patients (93.3%) in Group I and six patients (40%) in Group II returned to their preinjury sport activity level (P = .007). Median maximum knee flexion was 132° (121°–140°) in Group I and 134° (121°–139°) in Group II (n.s.). All patients had full knee extension and negative McMurray test results. Lachman and pivot shift test results were similar between groups. The median IKDC Questionnaire score was 99 (86–100) in Group I and 93 (70–100) in Group II (P = .016). The difference in Lysholm Knee Scoring Scale, HSS knee, and TA scale score between groups were not significant.

Conclusion

Clinical outcomes of patients that underwent meniscus repair were better than those that underwent meniscus resection with concurrent ACL reconstruction. The technically complicated and costly meniscus repair may achieve better clinical outcomes than meniscectomy when treating a neglected or delayed meniscal tear with a concurrent ACL tear.

Level of evidence

III.

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Funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Bursa Acibadem Hospital, FSM Bulvarı, Sumer sokak No:1, Nilufer, Bursa, Turkey

    Gokay Eken

  2. Department of Orthopaedics and Traumatology, Health Sciences University Gaziosmanpasa Training and Research Hospital, Karayolları, Osmanbey caddesi, 621 sokak, 34255, Gaziosmanpasa, 34255, İstanbul, Turkey

    Abdulhamit Misir

  3. Department of Orthopaedics and Traumatology, Bursa Medicana Hospital, Odunluk, Izmir Yolu caddesi No:41 Nilufer, Bursa, Turkey

    Burak Demirag

  4. Department of Orthopaedics and Traumatology, Bursa Yuksek Ihtisas Education and Research Hospital, Mimar Sinan mahallesi Yildirim, Bursa, Turkey

    Can Ulusaloglu

  5. Department of Orthopaedics and Traumatology, Cekirge Government Hospital, Hudavendigar mahallesi, Dobruca caddesi, No:2, Osmangazi, 16090, Bursa, Turkey

    Turan Bilge Kizkapan

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  1. Gokay Eken
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  2. Abdulhamit Misir
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Correspondence to Gokay Eken.

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Conflict of interest

Gokay Eken, Abdulhamit Misir, Burak Demirag, Can Ulusaloglu and Turan Bilge Kizkapan declare that they have no conflict of interest to declare.

Ethical approval

Uludag University Faculty of Medicine clinical investigations research ethics board approved the study protocol (Approval date/number 24.11.2015-2015-20/37).

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Eken, G., Misir, A., Demirag, B. et al. Delayed or neglected meniscus tear repair and meniscectomy in addition to ACL reconstruction have similar clinical outcome. Knee Surg Sports Traumatol Arthrosc 28, 3511–3516 (2020). https://doi.org/10.1007/s00167-020-05931-8

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