Favorable outcomes after all-inside repair of complete lateral meniscus oblique radial tears in patients undergoing anterior cruciate ligament reconstruction: A case-series study
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVES: To evaluate the outcomes of repairing lateral meniscus oblique radial tears of the posterior horn (LMORT) that are complete and originate >1 cm from the posterior root (type 4), during anterior cruciate ligament reconstruction (ACLR) at a minimum of 2 years of follow-up. METHODS: In this case series (March 2018-March 2023), we included adults undergoing primary ACLR with type 4 LMORT all-inside repair and complete ≥2-year postoperative complication data. We assessed change from baseline and minimal clinically important difference (MCID) rate for the Patient Reported Outcome Measures Information System Pain Interference (PROMIS-PI) and Mobility (PROMIS-MO), International Knee Documentation Committee Subjective Knee Form (IKDC), Activity Rating Scale (ARS) and Single Assessment Numeric Evaluation (SANE). Return-to-sport (RTS), same-level RTS and complication (retear of lateral meniscus, reoperation, ACLR graft failure, infection, contralateral knee surgery) rates were reported. When available, we evaluated second-look arthroscopy and postoperative magnetic resonance imaging (MRI) findings. RESULTS: In 16 cases (median follow-up; 37.3 [29.1-65.3] months), improvement was noted in median PROMIS-PI (60.3 [57.7-65.8] vs 43.0 [39.0-48.9]; p < 0.001), PROMIS-MO (38.5 [33.5-40.8] vs 61.1 [54.0-66.8]; p < 0.001), IKDC (42.0 [23.5-48.0] vs 91.4 [82.8-96.6]; p < 0.001) and SANE (25.0 [10.0-38.3] vs 89.0 [80.0-95.0]; p = 0.002). No statistically significant differences were observed for ARS (16.0 [13.0-16.0] vs 12.0 [8.0-14.5] p = 0.099). MCID rates were 85.7 %, 92.9 %, 100 %, 57.1 % and 78.6 % for PROMIS-PI, PROMIS-MO, IKDC, ARS and SANE, respectively. RTS and same-level RTS rates were 12/14 (85.7 %) and 8/14 (57.1 %), respectively. Three (18.8 %) patients underwent ipsilateral knee reoperations; none for lateral meniscus retears. There was one (6.3 %) contralateral knee operation. Complete LMORT repair healing was observed on available second-look arthroscopies and MRIs. CONCLUSIONS: Our study of patients with type 4 LMORT repair during ACLR supports the limited existing evidence by demonstrating statistically significant improvement in patient-reported outcome measures, low complication rates and satisfactory healing patterns. Our findings should further encourage all-inside repair of type 4 LMORTs during ACLR, as it results in high RTS and substantial same-level RTS. LEVEL OF EVIDENCE: IV. Case-series.
Institution: Hospital for Special Surgery
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
OpenAlex ID: W4415547263