Arthroscopic evaluation of meniscal repairs after anterior cruciate ligament reconstruction and immediate motion

Abstract

Sixty-six patients who had meniscal repair at the same time as an ACL reconstruction were followed-up with arthroscopy at an average of 12 months postopera tively. All patients underwent immediate postoperative range of motion from 20° to 90° and began partial weightbearing between the 1 st and 3rd postoperative weeks. The rate of meniscal healing was classified as complete, partial, or failed. We statistically analyzed the effect of rim width, length of the tear, type of meniscus, age of patient, length of time between injury and repair, length of time between surgery and follow-up arthros copy, and open versus arthroscopically assisted sur gical procedure on the rate of meniscal healing. The overall results showed that 63 (80%) of the menisci completely healed, 11 (14%) partially healed, and 5 (6%) failed. The only factor that had a statistically significant impact on the rate of healing was rim width. Repairs in the outer one-third region had a higher incidence of healing (98% retained menisci) than those in the central one-third region (79% retained menisci, P < 0.01). Still, the ability to repair a majority of central one-third meniscus tears that occur in the avascular zone (including flap tears and double longitudinal tears) suggest repair be considered when clinical grounds warrant preserving the meniscus. There were no com plications, nor were there any deleterious effects from immediate knee motion or early weightbearing on the meniscal repairs. This allows an aggressive, immediate motion program to be followed with ACL reconstruction when concomitant meniscus repair is performed.