High failure rate of anterior cruciate ligament reconstruction with bimeniscal repair: A case-control study.
Orthop Traumatol Surg Res
; 103(6): 943-946, 2017 10.
Article
en En
| MEDLINE
| ID: mdl-28552823
ABSTRACT
BACKGROUND:
Bimeniscal lesions are common in patients with anterior cruciate ligament (ACL) tears. However, bimeniscal repair is rarely performed during ACL reconstruction.OBJECTIVE:
To assess outcomes after ACL reconstruction with bimeniscal repair.HYPOTHESIS:
Bimeniscal lesions, even when repaired, are associated with poorer outcomes of ACL reconstruction. MATERIAL ANDMETHODS:
A retrospective case-control design was used. The cases were 15 patients who underwent ACL reconstruction, without procedures on any other ligaments, combined with bimeniscal repair, between May 2009 and May 2013 (3.2% of all ACL reconstructions during the study period). This group (2-Mc group) was matched on age, gender, body mass index, and time to surgery to 30 patients who underwent ACL reconstruction and had no meniscal lesions (0-Mc group) and to 30 patients who underwent ACL reconstruction and repair of the medial meniscus (1-Mc group). After a mean follow-up of 3.6 years, clinical outcomes were assessed based on the KOOS, Lysholm, and IKDC scores and knee laxity based on TELOS and GNRB measurements. The primary outcome measure was the rate of ACL re-rupture. Secondary outcome measures were functional outcomes and rate of delayed meniscectomy.RESULTS:
The ACL re-rupture rate was significantly higher in the 2-Mc group than in the 0-Mc and 1-Mc groups pooled (20%, vs. 1.7%; P=0.02). The functional scores showed no significant differences across groups. Post-operative differential laxity was significantly greater in the 2-Mc group (3.3mm by TELOS, P=0.02; and 2.5mm by GNRB, P=0.03) than in the 0-Mc and 1-Mc groups pooled. Delayed meniscectomy was performed in none of the 2-Mc group patients and in 2 of the 1-Mc group patients.CONCLUSION:
ACL reconstruction combined with bimeniscal repair is a rarely performed procedure. It is associated with a high ACL re-rupture rate and greater differential laxity. Meniscal outcomes of bimeniscal repair, in contrast, are good. LEVEL OF EVIDENCE III, matched case-control study.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Meniscos Tibiales
/
Reconstrucción del Ligamento Cruzado Anterior
/
Lesiones del Ligamento Cruzado Anterior
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Orthop Traumatol Surg Res
Año:
2017
Tipo del documento:
Article
País de afiliación:
Francia