{"title":"Side-to-side repair improves coronal meniscal extrusion in lateral meniscus oblique radial tears concomitant with anterior cruciate ligament reconstruction.","authors":"Kyota Ishibashi, Hikaru Kristi Ishibashi, Eiji Sasaki, Yuka Kimura, Yasuyuki Ishibashi","doi":"10.1002/jeo2.70916","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To determine the proportion of lateral meniscus oblique radial tear repairs during anterior cruciate ligament reconstruction and compare extrusion and clinical outcomes between side-to-side repair of lateral meniscus oblique radial tear and posterior longitudinal tear repair.</p><p><strong>Methods: </strong>Among 609 primary anterior cruciate ligament reconstructions from 2016 to 2023, 34 patients with intraoperatively confirmed lateral meniscus oblique radial tear underwent side-to-side repair and magnetic resonance imaging at 6 months and 1 year; 27 with posterior longitudinal tears underwent all-inside repair. Coronal and sagittal lateral meniscal extrusion, clinical outcomes, knee stability and Knee Injury and Osteoarthritis Outcome Score subscales were compared. Multivariate regression assessed predictors of preoperative-to-1-year coronal extrusion change; receiver operating characteristic analysis assessed whether preoperative lateral meniscal extrusion distinguished tear types.</p><p><strong>Results: </strong>Lateral meniscus oblique radial tear treated with side-to-side repair accounted for 7.4% of cases. Preoperative coronal lateral meniscal extrusion was greater in the lateral meniscus oblique radial tear group than in the longitudinal tear group (1.71 ± 1.31 vs. 0.32 ± 0.61 mm; <i>p</i> < 0.001). Coronal extrusion improved by approximately 0.6 mm after lateral meniscus oblique radial tear repair and was similar between groups at 1 year; sagittal extrusion increased slightly in both groups. Clinical outcomes were similar at 1 year and final follow-up. Preoperative coronal lateral meniscal extrusion was an independent predictor of coronal extrusion change (<i>β</i> = -0.514, <i>p</i> < 0.001). Preoperative coronal lateral meniscal extrusion >1.0 mm identified lateral meniscus oblique radial tear with acceptable diagnostic performance (area under the curve = 0.787, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Side-to-side lateral meniscus oblique radial tear repair during anterior cruciate ligament reconstruction reduced coronal extrusion by 1 year to levels comparable to those of longitudinal tear repair, with similar clinical outcomes. These findings support side-to-side repair as a reliable meniscal preservation strategy.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":36909,"journal":{"name":"Journal of Experimental Orthopaedics","volume":"13 3","pages":"e70916"},"PeriodicalIF":3.2000,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592544/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Experimental Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/jeo2.70916","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/7/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
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Abstract
Purpose: To determine the proportion of lateral meniscus oblique radial tear repairs during anterior cruciate ligament reconstruction and compare extrusion and clinical outcomes between side-to-side repair of lateral meniscus oblique radial tear and posterior longitudinal tear repair.
Methods: Among 609 primary anterior cruciate ligament reconstructions from 2016 to 2023, 34 patients with intraoperatively confirmed lateral meniscus oblique radial tear underwent side-to-side repair and magnetic resonance imaging at 6 months and 1 year; 27 with posterior longitudinal tears underwent all-inside repair. Coronal and sagittal lateral meniscal extrusion, clinical outcomes, knee stability and Knee Injury and Osteoarthritis Outcome Score subscales were compared. Multivariate regression assessed predictors of preoperative-to-1-year coronal extrusion change; receiver operating characteristic analysis assessed whether preoperative lateral meniscal extrusion distinguished tear types.
Results: Lateral meniscus oblique radial tear treated with side-to-side repair accounted for 7.4% of cases. Preoperative coronal lateral meniscal extrusion was greater in the lateral meniscus oblique radial tear group than in the longitudinal tear group (1.71 ± 1.31 vs. 0.32 ± 0.61 mm; p < 0.001). Coronal extrusion improved by approximately 0.6 mm after lateral meniscus oblique radial tear repair and was similar between groups at 1 year; sagittal extrusion increased slightly in both groups. Clinical outcomes were similar at 1 year and final follow-up. Preoperative coronal lateral meniscal extrusion was an independent predictor of coronal extrusion change (β = -0.514, p < 0.001). Preoperative coronal lateral meniscal extrusion >1.0 mm identified lateral meniscus oblique radial tear with acceptable diagnostic performance (area under the curve = 0.787, p < 0.001).
Conclusions: Side-to-side lateral meniscus oblique radial tear repair during anterior cruciate ligament reconstruction reduced coronal extrusion by 1 year to levels comparable to those of longitudinal tear repair, with similar clinical outcomes. These findings support side-to-side repair as a reliable meniscal preservation strategy.
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