Secondary Meniscectomy Rates and Risk Factors for Failed Repair of Ramp Lesions Performed at the Time of Primary ACL Reconstruction: An Analysis of 1037 Patients From the SANTI Study Group.

Autor:	Pioger C; Department of Orthopedic Surgery, Ambroise Paré Hospital, Paris Saclay University, Paris, France., Ayata M; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France., Pettinari F; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France., Ali AA; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France., Alayane A; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France., Campos JP; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France., Vieira TD; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France., Saithna A; AZBSC Orthopedics, Scottsdale, Arizona, USA.; Arizona State University, Tempe, Arizona, USA., Sonnery-Cottet B; Centre Orthopédique Santy, Lyon, France.; Hôpital Privé Jean Mermoz, Ramsay-Générale de Santé, Lyon, France.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 Jul; Vol. 52 (8), pp. 1944-1951. Date of Electronic Publication: 2024 Jun 10.
DOI:	10.1177/03635465241253841
Abstrakt:	Background: Studies evaluating secondary meniscectomy rates and risk factors for failure of ramp repair are sparse and limited by small numbers and heterogeneity. Purposes/hypothesis: The purposes were to determine the secondary meniscectomy rate for failure of ramp repair performed using a posteromedial portal suture hook at the time of anterior cruciate ligament reconstruction (ACLR) and to identify risk factors for secondary meniscectomy. It was hypothesized that patients who underwent ACLR combined with a lateral extra-articular procedure (LEAP) would experience significantly lower rates of secondary meniscectomy compared with those undergoing isolated ACLR. Study Design: Case-control study; Level of evidence, 3. Methods: Patients undergoing primary ACLR and ramp repair between 2013 and 2020 were included in the study. Final follow-up for each patient was defined by his or her last appointment recorded in a prospective database (with a study end date of March 2023). The database and medical records were used to determine whether patients had undergone secondary meniscectomy for failure of ramp repair. Survivorship of ramp repair (using secondary meniscectomy as an endpoint) was determined using the Kaplan-Meier method. Multivariate analysis was used to investigate possible risk factors. Results: A total of 1037 patients were included in the study. The secondary meniscectomy rate after ramp repair was 7.7% at a mean final follow-up of 72.4 months. Patients without combined ACLR + LEAP were >2-fold more likely to undergo a secondary medial meniscectomy compared with those with combined ACLR + LEAP (hazard ratio, 2.455; 95% CI, 1.457-4.135; P = .0007). Age, sex, preoperative Tegner score, and time between injury and surgery were not significant risk factors for failure. Conclusion: The rate of secondary meniscectomy after ramp repair performed through a posteromedial portal at the time of primary ACLR was low. Patients who underwent isolated ACLR (rather than ACLR + LEAP) were >2-fold more likely to undergo a secondary medial meniscectomy for failure of ramp repair. Additional risk factors for failure of ramp repair were not identified. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: GCS Ramsay Sante funds the scientific activity at the Santy center. Arthrex cofunds studies at the Santy center through research grants. B.S-C. has received consulting fees and royalties from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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