Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: Results From the MARS Cohort
Authors:   MARS Group, Wright Rick W. , Huston Laura J. , Haas Amanda K. , Nwosu Samuel K. , Allen Christina R. , Anderson Allen F. , Cooper Daniel E. , DeBerardino Thomas M. , Dunn Warren R. , Lantz Brett (Brick) A. , Mann Barton , Spindler Kurt P. , Stuart Michael J. , Pennings Jacquelyn S. , Albright John P. , Amendola Annunziato (Ned) , Andrish Jack T. , Annunziata Christopher C. , Arciero Robert A. , Bach Jr Bernard R. , Baker Champ L. , Bartolozzi Arthur R. , Baumgarten Keith M. , Bechler Jeffery R. , Berg Jeffrey H. , Bernas Geoffrey A. , Brockmeier Stephen F. , Brophy Robert H. , Bush-Joseph Charles A. , Butler V J. Brad , Campbell John D. , Carey James L. , Carpenter James E. , Cole Brian J. , Cooper Jonathan M. , Cox Charles L. , Creighton R. Alexander , Dahm Diane L. , David Tal S. , Flanigan David C. , Frederick Robert W. , Ganley Theodore J. , Garofoli Elizabeth A. , Gatt Charles J. , Gecha Steven R. , Giffin James Robert , Hame Sharon L. , Hannafin Jo A. , Harner Christopher D. , Harris Norman Lindsay , Hechtman Keith S. , Hershman Elliott B. , Hoellrich Rudolf G. , Hosea Timothy M. , Johnson David C. , Johnson Timothy S. , Jones Morgan H. , Kaeding Christopher C. , Kamath Ganesh V. , Klootwyk Thomas E. , Levy Bruce A. , Ma C. Benjamin , Maiers G. Peter , Marx Robert G. , Matava Matthew J. , Mathien Gregory M. , McAllister David R. , McCarty Eric C. , McCormack Robert G. , Miller Bruce S. , Nissen Carl W. , O’Neill Daniel F. , Owens Brett D. , Parker Richard D. , Purnell Mark L. , Ramappa Arun J. , Rauh Michael A. , Rettig Arthur C. , Sekiya Jon K. , Shea Kevin G. , Sherman Orrin H. , Slauterbeck James R. , Smith Matthew V. , Spang Jeffrey T. , Steven J. Svoboda LTC , Taft Timothy N. , Tenuta Joachim J. , Tingstad Edwin M. , Vidal Armando F. , Viskontas Darius G. , White Richard A. , Williams Jr James S. , Wolcott Michelle L. , Wolf Brian R. , York James J. 
Published: August 2020

Background:

Meniscal preservation has been demonstrated to contribute to long-term knee health. This has been a successful intervention in patients with isolated tears and tears associated with anterior cruciate ligament (ACL) reconstruction. However, the results of meniscal repair in the setting of revision ACL reconstruction have not been documented.

Purpose:

To examine the prevalence and 2-year operative success rate of meniscal repairs in the revision ACL setting.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

All cases of revision ACL reconstruction with concomitant meniscal repair from a multicenter group between 2006 and 2011 were selected. Two-year follow-up was obtained by phone and email to determine whether any subsequent surgery had occurred to either knee since the initial revision ACL reconstruction. If so, operative reports were obtained, whenever possible, to verify the pathologic condition and subsequent treatment.

Results:

In total, 218 patients (18%) from 1205 revision ACL reconstructions underwent concurrent meniscal repairs. There were 235 repairs performed: 153 medial, 48 lateral, and 17 medial and lateral. The majority of these repairs (n = 178; 76%) were performed with all-inside techniques. Two-year surgical follow-up was obtained on 90% (197/218) of the cohort. Overall, the meniscal repair failure rate was 8.6% (17/197) at 2 years. Of the 17 failures, 15 were medial (13 all-inside, 2 inside-out) and 2 were lateral (both all-inside). Four medial failures were treated in conjunction with a subsequent repeat revision ACL reconstruction.

Conclusion:

Meniscal repair in the revision ACL reconstruction setting does not have a high failure rate at 2-year follow-up. Failure rates for medial and lateral repairs were both <10% and consistent with success rates of primary ACL reconstruction meniscal repair. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears.