Delayed Meniscus Repair Lowers the Functional Outcome of Primary ACL Reconstruction

Patrick Sadoghi; Harald K Widhalm; Martin F Fischmeister; Lukas Leitner; Andreas Leithner; Stefan F Fischerauer

doi:10.3390/jcm13051325

Delayed Meniscus Repair Lowers the Functional Outcome of Primary ACL Reconstruction

J Clin Med. 2024 Feb 26;13(5):1325. doi: 10.3390/jcm13051325.

Authors

Patrick Sadoghi¹, Harald K Widhalm², Martin F Fischmeister³, Lukas Leitner¹, Andreas Leithner¹, Stefan F Fischerauer¹

Affiliations

¹ Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria.
² Clinical Division of Traumatology, Department of Orthopedics and Traumatology, Medical University of Vienna, 1090 Vienna, Austria.
³ AUVA Traumacenter Unfallkrankenhaus Linz, 4017 Linz, Austria.

Abstract

Background: Our purpose was to evaluate whether the time of intervention and the type of meniscus surgery (repair vs. partial meniscectomy) play a role in managing anterior cruciate ligament (ACL) reconstructions with concurrent meniscus pathologies.

Methods: We performed a prospective cohort study which differentiated between early and late ACL reconstructions with a cut-off at 3 months. Patients were re-evaluated after 2 years.

Results: Thirty-nine patients received an operation between 2-12 weeks after the injury, and thirty patients received the surgery between 13-28 weeks after trauma. The strongest negative predictive factor of the International Knee Documentation Committee subjective knee form in a hierarchical regression model was older age (ß = -0.49 per year; 95% CI [-0.91; -0.07]; p = 0.022; partial R² = 0.08)). The strongest positive predictive factor was a higher preoperative Tegner score (ß = 3.6; 95% CI [0.13; 7.1]; p = 0.042; partial R² = 0.07) and an interaction between meniscus repair surgery and the time of intervention (ß = 27; 95% CI [1.6; 52]; p = 0.037; partial R² = 0.07), revealing a clinical meaningful difference as to whether meniscus repairs were performed within 12 weeks after trauma or were delayed. There was no difference whether partial meniscectomy was performed early or delayed.

Conclusions: Surgical timing plays a crucial role when surgeons opt for a meniscus repair rather than for a meniscectomy.

Keywords: anterior cruciate ligament reconstruction; early versus delayed surgery; meniscus.

Grants and funding

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payment or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.