Partial meniscectomy does not affect the biomechanics of anterior cruciate ligament reconstructed knee with a lateral posterior meniscal root tear

Background: Meniscal posterior root tears, which are often associated with anterior cruciate ligament (ACL) injury, lead to the loss of normal biomechanical and kinematic behavior of menisci. Several arthroscopic techniques have been introduced to address this kind of injury. In this video, a simple all-inside technique to repair posterior lateral root tear (PLRT) is presented. Indications: To repair type 1, type 2, and type 4 PLRT. Technique: The torn lateral meniscus root is sutured to the medial fibers of the posterior cruciate ligament (PCL), with an arthroscopic all-inside repair system, with the purpose of reproducing the stabilizing function of the meniscofemoral ligaments. Results: This procedure allows restoration of the correct position of the detached horn, and restores meniscal stability with satisfactory clinical outcomes. Discussion/Conclusion: The technique described represents a simple and fast arthroscopic all-inside procedure to repair PLRT in association with concomitant procedure, such as ACL reconstruction. However, outcome reports of this technique are still lacking in the literature, and further studies are needed to confirm the authors’ results.

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Tibiofemoral contact forces protect against articular tissue damage in the anterior cruciate ligament reconstructed knee, but not if there is concurent meniscal injury

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2016.01.195 ◽

2016 ◽

Vol 24 ◽

pp. S94 ◽

Cited By ~ 3

Author(s):

D.J. Saxby ◽

X. Wang ◽

A.L. Bryant ◽

L. Modenese ◽

P. Gerus ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Tissue Damage ◽

Cruciate Ligament ◽

Contact Forces ◽

Meniscal Injury ◽

Anterior Cruciate ◽

Reconstructed Knee

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Complete Posterior Lateral Meniscal Root Lesion is Associated with High-Grade Pivot-Shift Phenomenon in Noncontact Anterior Cruciate Ligament Injuries

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2017.08.101 ◽

2017 ◽

Vol 33 (10) ◽

pp. e98

Author(s):

Guanyang Song ◽

Hua Feng

Keyword(s):

Anterior Cruciate Ligament ◽

Pivot Shift ◽

Cruciate Ligament ◽

High Grade ◽

Ligament Injuries ◽

Anterior Cruciate Ligament Injuries ◽

Meniscal Root ◽

Anterior Cruciate

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Partial meniscectomy adversely affects return-to-sport outcome after anatomical double-bundle anterior cruciate ligament reconstruction

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-018-5213-y ◽

2018 ◽

Vol 27 (3) ◽

pp. 912-920 ◽

Cited By ~ 1

Author(s):

Takanori Akada ◽

Ichiro Yamaura ◽

Ashish Gupta ◽

Hiroki Sakai ◽

Kenji Takahashi ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Return To Sport ◽

Double Bundle ◽

Partial Meniscectomy ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

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The Incidence of Subsequent Meniscal Surgery Is Higher in the Anterior Cruciate Ligament–Reconstructed Knee Than in the Contralateral Knee

The American Journal of Sports Medicine ◽

10.1177/0363546517721685 ◽

2017 ◽

Vol 45 (14) ◽

pp. 3216-3222 ◽

Cited By ~ 9

Author(s):

Brent R. Davis ◽

Jason Chen ◽

Maria C.S. Inacio ◽

Rebecca Love ◽

Heather A. Prentice ◽

...

Keyword(s):

Risk Factors ◽

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Absolute Risk ◽

Cruciate Ligament ◽

Free Survival ◽

Contralateral Knee ◽

Meniscal Surgery ◽

Anterior Cruciate ◽

Reconstructed Knee

Background: A goal of anterior cruciate ligament (ACL) reconstruction is to provide a meniscal protective effect for the knee. Purpose: (1) To evaluate whether there was a different likelihood of subsequent meniscal surgery in the ACL-reconstructed knee or in the normal contralateral knee and (2) to compare the risk factors associated with subsequent meniscal surgery in the ACL-reconstructed knee and contralateral knee. Study Design: Cohort study; Level of evidence, 3. Methods: Using an integrated health care system’s ACL reconstruction registry, patients undergoing primary ACL reconstruction, with no meniscal injury at the time of index surgery and a normal contralateral knee, were evaluated. Subsequent meniscal tears associated with ACL graft revision were excluded. Subsequent meniscal surgery in either knee was the outcome of interest. Sex, age, and graft type were assessed as potential risk factors. Survival analysis was used to compare meniscal surgery–free survival rates and to assess risk factors of subsequent meniscal surgery. Results: Of 4087 patients, there were 32 (0.78%) patients who underwent subsequent meniscal surgery in the index knee and 9 (0.22%) in the contralateral knee. The meniscal surgery–free survival rate at 4 years was 99.08% (95% CI, 98.64%-99.37%) in the index knee and 99.65% (95% CI, 99.31%-99.82%) in the contralateral knee. There was a 3.73 (95% CI, 1.73-8.04; P < .001) higher risk of subsequent meniscal surgery in the index knee compared with the contralateral knee, or a 0.57% absolute risk difference. After adjustments, allografts (hazard ratio [HR], 5.06; 95% CI, 1.80-14.23; P = .002) and hamstring autografts (HR, 3.11; 95% CI, 1.06-9.10; P = .038) were risk factors for subsequent meniscal surgery in the index knee compared with bone–patellar tendon–bone (BPTB) autografts. Conclusion: After ACL reconstruction, the overall risk of subsequent meniscal surgery was low. However, the relative risk of subsequent meniscal surgery in the ACL-reconstructed knee was higher compared with the contralateral knee. Only graft type was found to be a risk factor for subsequent meniscal surgery in the ACL-reconstructed knee, with a higher risk for allografts and hamstring autografts compared with BPTB autografts.

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The Occurrence of Meniscal and Chondral Injury in Two-Stage Revision Anterior Cruciate Ligament Reconstruction: A Consecutive Case Series

The Journal of Knee Surgery ◽

10.1055/s-0038-1677543 ◽

2019 ◽

Vol 33 (03) ◽

pp. 223-227

Author(s):

Floris R. van Tol ◽

Willem A. Kernkamp ◽

Robert J. P. van der Wal ◽

Jan-Willem A. Swen ◽

Samuel K. Van de Velde ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Meniscal Tear ◽

Partial Meniscectomy ◽

Two Stage ◽

Revision Acl Reconstruction ◽

Chondral Injury ◽

Anterior Cruciate ◽

Two Stages

AbstractTwo-stage revision anterior cruciate ligament (ACL) reconstruction is an effective way to revise suboptimal tunnel-placement allowing for proper graft fixation. However, prolonged increased laxity of the knee may increase the risk of meniscal or chondral injury. It was hypothesized that no additional meniscal or chondral lesions occur in between the two stages of the two-stage revision ACL reconstruction. In this retrospective study, 42 patients undergoing a two-stage revision ACL reconstruction were included. Surgical notes for both stages were screened for meniscal and chondral status, interventions to any concurrent injury, surgery dates, along with basic patient characteristics. In 4 of the 42 patients, a new meniscal tear occurred in between the two stages, of which three required partial meniscectomy during the second stage of the ACL revision. One patient experienced a new small degenerative tear that did not require intervention. Two out of the four menisci that were repaired during the first stage had failed and required partial meniscectomy. No significant difference was found in the time between the two stages with respect to the occurrence of meniscal tears. No significant differences in chondral status were found. In conclusion, approximately 10% of patients developed a new meniscal tear and no difference in macroscopic chondral injury was observed between the first and second stages.

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