Evaluation of Outcomes at Mean 4.8 Years After Repair of Types 3 and 4 Lateral Meniscal Oblique Radial Tears during ACL Reconstruction.

Abstract

Background: Lateral meniscal oblique radial tears (LMORTs) of the posterior horn typically occur in the setting of an acute anterior cruciate ligament (ACL) rupture. Despite publications pertaining to the prevalence, biomechanics, and surgical repair techniques of LMORTs, studies reporting mid-term outcomes after LMORT repair are lacking.

Purpose: To examine both clinical and functional outcomes after the surgical repair of LMORTs.

Study design: Case series; Level of evidence, 4.

Methods: A retrospective chart review was conducted on 845 patients who underwent a meniscal repair at The Ohio State University Sports Medicine Center from 2017 to 2019. Operative reports and images were manually reviewed to identify LMORTs occurring concomitantly with ACL rupture. Subsequent knee surgery, meniscal repair failure, and postoperative complications were identified, with failure defined as retear at the same meniscal site. Patients without at least 2 years of follow-up were excluded. Patients were contacted postoperatively for evaluation of patient-reported outcomes (PROs)-including the Knee injury and Osteoarthritis Outcome Score (KOOS), Marx activity rating scale (Marx), and pain on a visual analog scale (VAS).

Results: A total of 25 patients were identified who underwent repair of an LMORT at the time of ACL reconstruction during the study period, with 18 patients available for a 2-year follow-up. The mean age was 21.3 ± 5 years, the mean body mass index was 26.7 ± 4.3 kg/m², and 56% of patients were men. The mean follow-up was 4.8 ± 1 years. There were no identified failures of LMORT repair. Postoperative complications were reported in 9 patients (50%), of whom 7 underwent repeat arthroscopy of the index knee for stiffness, pain, and/or repeat injury. The mean follow-up was 4.9 years from the initial date of surgery. The mean KOOS, Marx, and VAS scores were 86.5 ± 8.6, 7.1 ± 4.7, and 2.1 ± 1.4, respectively.

Conclusion: LMORT repair is associated with a low risk of failure and favorable PRO measures at the mid-term follow-up. However, a complication rate of 50% was found within the cohort because of joint stiffness, postoperative pain, and reinjury of the index knee.