Delayed Meniscus Repair Lowers the Functional Outcome of Primary ACL Reconstruction

• Published in: Journal of clinical medicine Vol. 13; no. 5; p. 1325
• Main Authors: Sadoghi, Patrick, Widhalm, Harald K, Fischmeister, Martin F, Leitner, Lukas, Leithner, Andreas, Fischerauer, Stefan F
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26-02-2024; MDPI
• Subjects: Intervention; Joint and ligament injuries; Knee; Orthopedic surgery; Osteoarthritis; Patients; Surgeons; Surgery; Sutures; Variables; Austria; anterior cruciate ligament reconstruction; early versus delayed surgery; meniscus
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13051325

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.
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.
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];
= 0.022; partial R
= 0.08)). The strongest positive predictive factor was a higher preoperative Tegner score (ß = 3.6; 95% CI [0.13; 7.1];
= 0.042; partial R
= 0.07) and an interaction between meniscus repair surgery and the time of intervention (ß = 27; 95% CI [1.6; 52];
= 0.037; partial R
= 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.
Surgical timing plays a crucial role when surgeons opt for a meniscus repair rather than for a meniscectomy.