Description
Background: Due to the lack of sufficient evidence, there is still controversy regarding the ideal management method for meniscal tears combined with anterior cruciate ligament (ACL) injury, especially for professional athletes.
Purpose/Hypothesis: The primary objective of this study was to describe the incidence of meniscal lesions in professional athletes undergoing primary ACL reconstruction. The second objective was to determine the failure rate of medial meniscal (MM) and/or lateral meniscal (LM) repair in this specific population during long-term follow-up and to identify the associated risk factors.
Methods: This was a retrospective comparative study. All patients who were defined as professional athletes underwent arthroscopic primary ACL reconstruction and repair of medial and/or lateral meniscal tears from January 2013 to December 2022. Risk factors associated with secondary meniscectomy were analyzed using a logistic regression model.
Study design: This was a retrospective cohort study (level of evidence: 4).
Results: A total of 196 patients were included in the study, with a mean follow-up of 95.8 (SD 45.1) months. The mean age was 23.3 (SD 5.0) years, and the mean Tegner score was 9.3 (SD 1.0). The most common type of graft used was hamstring tendon grafts, which were used in 74.0% of the patients, 74% of whom underwent a concomitant lateral extra-articular procedure. A total of 37% and 29% of patients had lateral and medial meniscus lesions, respectively, with 34% having both LM and MM lesions. For LM tears, the most common type of repair was all-inside repair technique. For MM tears, the most common type of repair was suture hook repair. Overall, 7 (5.0%) and 19 (15.4%) patients underwent a second lateral and medial meniscectomy, respectively. A Cox model showed no significant risk factors associated with secondary lateral or medial meniscectomy.
Conclusions: Our study showed that among the included professional athletes with an ACL rupture, 37% had LM lesions, 29% had MM lesions, and 34% had lesions in both menisci. At long-term follow-up, the meniscal repair failure rate in this population of patients who underwent primary ACL reconstruction was 5% for LM tears and 15.4% for MM tears. No risk factors for secondary meniscectomy were found.
