Meniscal survival rate after anterior cruciate ligament reconstruction
| Autor: | T Ameline, G. Le Henaff, Romain Seil, François Dalmay, F.-X. Gunepin, F P Ehkirch, T. Cucurulo, Bertrand Sonnery-Cottet, la Sfa, C. Lutz, C. Laporte, J.-F. Potel, Nicolas Pujol, E Sallé de Chou, G. Rochcongar |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Anterior cruciate ligament reconstruction Anterior cruciate ligament medicine.medical_treatment Meniscal suture Meniscus (anatomy) Menisci Tibial Young Adult Recurrence Risk Factors medicine Humans Orthopedics and Sports Medicine Normal meniscus Anterior Cruciate Ligament Survival rate Retrospective Studies Lateral meniscus Wound Healing Anterior Cruciate Ligament Reconstruction business.industry Retrospective cohort study Meniscal survival Middle Aged musculoskeletal system Surgery Tibial Meniscus Injuries Survival Rate medicine.anatomical_structure Case-Control Studies Tears Female business |
| Zdroj: | Orthopaedicstraumatology, surgeryresearch : OTSR. 101 |
| ISSN: | 1877-0568 |
| Popis: | Background Meniscal suture provides well-documented benefits. Integrity of the cruciate ligaments of the knee is a prerequisite for meniscal healing. Nevertheless, reconstruction of the anterior cruciate ligament (ACL) does not consistently prevent recurrent tearing of a sutured meniscus. We evaluated meniscal survival rates, 5 and 10 years after meniscal suture concomitant with an ACL reconstruction. We compared the outcomes of these repaired menisci to those in which no menisci tears were detected during ACL reconstruction. Methods In this multi-centric retrospective study, we included two groups. One group consists of patients who underwent a meniscal repair. This group was further divided into two subgroups based on whether follow-up was 5 years ( n = 76) or 10 years ( n = 39). The control group included 120 patients with normal menisci observed during surgery. We studied meniscal survival rates in each group, and we analyzed risk factors associated with the recurrence of meniscal lesions. Results The 5-year meniscal survival rate was significantly higher in the control group than in the meniscal-repair group (95% vs. 80%, respectively; P = 0.0029). The controls group also had a higher meniscal survival rate after 10 years, although the difference was not statistically significant (88% vs. 77%, P = 0.07). A difference in knee laxity greater than 4 mm was associated with a 5-fold increase in the risk of recurrent meniscal tears ( P = 0.0057). After 5 years, the risk of recurrence was higher for the medial than for the lateral meniscus, whereas after 10 years the difference was no longer statistically significant. Discussion Although insufficient healing after meniscal suturing contributes to the risk of further meniscal tears, new lesions can develop in menisci that were undamaged at the time of ACL reconstruction. The risk of a new meniscal lesion is strongly associated with inadequate control of antero-posterior and rotational laxity. Some apparently “new menisci lesions” seems to have been missed during ACL reconstruction. Level of evidence IV, retrospective study. |
| Databáze: | OpenAIRE |
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