KSSTA - 2026-04-14 - Journal Article
Increasing meniscal repair rates during ACL reconstruction did not increase reoperation risk: An analysis of surgical trends from 2015 to 2023.
Kekki C, Essen CV, Cristiani R, Stålman A
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Original Abstract
PURPOSE
To evaluate surgical trends over time in meniscal procedures during anterior cruciate ligament reconstruction (ACLR) and compare meniscal reoperation rates and subjective outcomes between 2015-2019 and 2020-2023.
METHODS
This study included 2748 knees undergoing primary ACLR with concomitant meniscal procedures at Capio Artro Clinic, Stockholm, Sweden, stratified by time period (2015-2019 vs. 2020-2023). Meniscal reoperations within two years were identified through medical records, Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at two years for patients undergoing meniscal repair. Minimal important change (MIC), patient-acceptable symptom state (PASS) and treatment failure (TF) were assessed through KOOS 4 . Subgroup analysis compared reoperation rates following medial, lateral and combined medial and lateral meniscal procedures.
RESULTS
The proportion of meniscal repairs increased (18.0%-30.2%, p < 0.001), whereas meniscal resections decreased (21.1%-15.1%, both p < 0.001) from 2015-2019 to 2020-2023. Meniscal reoperation rates did not differ significantly between cohorts for repairs (9.0% vs. 11.4%, p = not significant (n.s.)) or resections (5.0% vs. 3.9%, p = n.s.). Combined medial and lateral meniscal procedures had significantly higher meniscal reoperation rates overall (11.7%) compared to medial (6.5%) and lateral (7.8%) meniscal procedures (p < 0.001). Lateral meniscal resections resulted in significantly more reoperations (2.8%) compared to medial (1.4%) and combined (1.5%) meniscal resections (p = 0.04) within the full cohort. There were no significant differences between cohorts in MIC, PASS, or TF. Multivariable analysis showed lower odds of reoperation in 2020-2023 compared to 2015-2019 (odds ratio [OR] = 0.39; 95% confidence interval [CI] 0.26-0.60; p < 0.001).
CONCLUSION
Meniscal repair rates during ACLR increased significantly over time, while short-term reoperation rates and patient-reported outcomes remained unchanged. These findings align with the increasing emphasis on meniscal preservation in clinical practice.
LEVEL OF EVIDENCE
Level III.