Outcomes After Anterior Cruciate Ligament Reconstruction Using the Norwegian Knee Ligament Registry of 4691 Patients

LaPrade, Christopher M.; Dornan, Grant J.; Granan, Lars-Petter; LaPrade, Robert F.; Engebretsen, Lars

doi:10.1177/0363546515577364

Cited by 58 publications

(95 citation statements)

References 23 publications

(56 reference statements)

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“…However, surgery to the lateral meniscus might have superior patient reported outcomes compared with surgery to the medial meniscus but the differences are small, which make the findings difficult to interpret 33. The differences between the presence of mensical injury or not, and meniscal treatment appear to decrease over time.…”

Section: Discussionmentioning

confidence: 96%

Factors that affect patient reported outcome after anterior cruciate ligament reconstruction–a systematic review of the Scandinavian knee ligament registers

et al. 2018

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Section: Discussionmentioning

confidence: 96%

Factors that affect patient reported outcome after anterior cruciate ligament reconstruction–a systematic review of the Scandinavian knee ligament registers

et al. 2018

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“…Preserving the meniscus in ACLR should be sought for whenever possible [31]. It improves subjective outcomes, objective knee stability, shows lower re-operation rates and prevents the progression of osteoarthritis in the long term [1,9,14,32,33]. At the same time, current research is underlining that early ACLR improves the outcome after meniscal repair in conjunction with ACLR while protecting the knee from secondary injury like chondral lesions and aggravated meniscal lesions [1,2,34].…”

Section: Discussionmentioning

confidence: 99%

“…This can be well explained by the additional stability provided by the menisci [13]. Subgroup-analyses suggest that patients requiring medial meniscal repair may have slightly worse long-term outcome in subjective function and higher risk of developing intrameniscal cysts compared to lateral repair [11,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

The effect of meniscal repair on strength deficits 6 months after ACL reconstruction

Heitner²,

Mauch³

et al. 2020

Arch Orthop Trauma Surg

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Introduction Ruptures of the anterior cruciate ligament (ACL) can be accompanied by meniscal lesions. Generally, the rehabilitation protocols are altered by meniscal repair. Therefore, the aim of this study was to investigate the effect of meniscal repair on the early recovery of thigh muscle strength in ACL reconstruction (ACLR). Materials and methods We performed a matched cohort analysis of n = 122 isolated ACLR (CON) compared to n = 61 ACLR with meniscal repair (ACLR + MR). The subgroups of meniscal repair consisted of 30 patients who had undergone medial meniscus repairs (MM), 19 lateral meniscus repairs (LM) and 12 repairs of medial and lateral meniscus (BM). Isokinetic strength measurement was performed pre-operatively and 6 months post-surgery to perform a cross-sectional and a longitudinal analysis. All injuries were unilateral, and the outcome measures were compared to the non-affected contralateral leg. Results Six months postoperatively overall there is no significant difference between the groups (extension strength MR 82% vs. CON 85% and flexion strength 86% vs. 88%, resp.). Subgroup analysis showed that medial repairs exhibit a comparable leg symmetry while lateral repairs performed worse with leg symmetry being 76% in extension and 81% in flexion strength. Patients undergoing BM repair performed in between lateral and medial repairs (82% extension, 86% flexion). Conclusion Generally, meniscal repair in conjunction with ACLR does not significantly alter the recovery of limb symmetry in strength at 6 months postoperatively. Interestingly, medial repairs seem to perform superior to lateral meniscal repair and repair of both menisci. Since the recovery of symmetric strength is a major factor in rehabilitation testing, these results will help to advise surgeons on appropriate rehabilitation protocols and setting realistic goals for the injured athlete. Level of evidence III, retrospective cohort study.

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“…In the Norwegian Knee Ligament Registry 18 patient-reported pain 2-years after ACLR did not differ among those who underwent ACLR with or without meniscal surgery (repair or resection). Pre-operative pain scores, however, were more likely to be lower with concurrent meniscal pathology on both the medial or lateral sides.…”

Section: Introductionmentioning

confidence: 88%

Clinical and radiographic outcomes of meniscus surgery and future targets for biologic intervention: A review of data from the MOON Group

Westermann

Jones

Wasserstein

et al. 2017

Connective Tissue Research

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Meniscus injury and treatment occurred with the majority of anterior cruciate ligament reconstructions (ACLR) in the multicenter orthopaedic outcomes (MOON) cohort. We describe the patient reported outcomes, radiographic outcomes and predictors of pain from meniscus injuries and treatment in the setting of ACLR. Patient reported outcomes improve significantly following meniscus repair with ACLR, but differences exist based on the meniscus injury laterally (medial or lateral). Patients undergoing medial meniscus repair have worse patient-reported outcomes and more pain compared to those with uninjured menisci. However, lateral meniscal tears can be repaired with similar outcomes as uninjured menisci. Medial meniscal treatment (meniscectomy or repair) results in a significant loss of joint space at 2 years compared to uninjured menisci. Menisci treated with excision had a greater degree of joint space loss compared to those treated with repair. Clinically significant knee pain is more common following injuries to the medial meniscus and increased in patients who undergo early re-operation after initial ACLR. Future research efforts aimed at improving outcomes after combined ACLR and meniscus treatment should focus on optimizing biologic and mechanical environments that promote healing of medial meniscal tears sustained during ACL injury.

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Outcomes After Anterior Cruciate Ligament Reconstruction Using the Norwegian Knee Ligament Registry of 4691 Patients

Abstract: Patients with ACLR with meniscal resections do not exhibit decreased clinical outcomes at 2 years postoperatively. It is recommended that clinicians follow patients with ACLR and concurrent meniscal treatment for longer than 2 years postoperatively.

Cited by 58 publications

References 23 publications

Factors that affect patient reported outcome after anterior cruciate ligament reconstruction–a systematic review of the Scandinavian knee ligament registers

Factors that affect patient reported outcome after anterior cruciate ligament reconstruction–a systematic review of the Scandinavian knee ligament registers

The effect of meniscal repair on strength deficits 6 months after ACL reconstruction

Clinical and radiographic outcomes of meniscus surgery and future targets for biologic intervention: A review of data from the MOON Group

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