Recommendations for Repair of Three Types of Anterior Cruciate Ligament Injuries with Combined Specific Meniscal Injuries

Abstract

Anterior cruciate ligament (ACL) injury plays an important role in affecting the stability of the knee of patients. ACL injuries often have meniscus injuries. When ACL is combined with special types of meniscus injuries, there are still research gaps on the therapeutic effect of ACLR. The article analyzes the impact on ACLR in terms of its injury mechanism and treatment for three specific types of meniscus: ramp lesions, bucket-handle tear (BHT), and root injury. It is not necessary to repair stable ramp lesions, nor does it affect the rate of recovery of motion. ACL injuries, combined with meniscal BHT, usually result in significant knee instability, causing further damage to the meniscus and articular cartilage and affecting ACLR outcomes. Therefore, simultaneous repair is recommended. If ACLR is performed over three months after injury, the timing positively correlates with the medial meniscus tear rate. BHT during simultaneous repair can lead to the risk of postoperative arthroplasty surgical revision. When combined with root injury, root tears which happened in lateral meniscus after ACLR lead to increased tibial anterior translation, and posterior root tears of lateral meniscus can further disrupt the ACL stability of reconstructed knee joint. Repairing posterior lateral meniscal root tears with good short-term clinical results is recommended.