KSSTA - 2026-08-10 - Journal Article
Anterior cruciate ligament reconstruction with concomitant all-inside lateral meniscus posterior root repair shows comparable graft survivorship and clinical outcomes to isolated ACL reconstruction.
Carrozzo A, Bérard É, Petrini T, Ben Roummane H, Geiger M, Pailhé R, Cavaignac E
Topics
Key Takeaway
Concomitant all-inside lateral meniscus posterior root repair during ACLR showed no significant difference in graft rerupture-free survival versus isolated ACLR (9.1% vs. 5.2%, HR 1.5, 95% CI 0.6–3.9), while professional athlete status independently doubled rerupture risk (HR 2.8).
Summary Depth
Choose how much analysis to show on this article page.
Summary
This single-center, single-surgeon retrospective cohort compared graft rerupture-free survival and clinical outcomes between isolated ACLR and ACLR with concomitant all-inside lateral meniscus posterior root repair using a standardized three-strand pedicled hamstring autograft. Graft rerupture occurred in 5.2% of isolated ACLR versus 9.1% of combined cases (p=0.216), with no significant difference on Kaplan-Meier or adjusted Cox regression analysis. Return to sport, return to work, contralateral ACL rupture rate, and 12-month Simple Knee Value were comparable between groups.
Key Limitation
The LMPR repair cohort (n=55) is substantially smaller than the isolated ACLR cohort, leaving the study underpowered to exclude a clinically important increase in rerupture risk given the HR of 1.5 with a wide confidence interval.
Original Abstract
PURPOSE
To compare anterior cruciate ligament (ACL) graft survivorship and clinical outcomes after isolated anterior cruciate ligament reconstruction (ACLR) versus ACLR combined with all-inside lateral meniscus posterior root (LMPR) repair.
METHODS
This single-centre, single-surgeon retrospective comparative cohort study included consecutive patients undergoing ACLR between January 2017 and December 2023 with a minimum 24-month follow-up. Patients underwent isolated ACLR or ACLR with all-inside LMPR repair according to intraoperative findings. A standardised anatomic single-bundle ACLR with a three-strand pedicled hamstring tendon autograft was used in all cases. The primary endpoint was graft rerupture-free survival. Secondary endpoints included return to sport (RTS), return to work (RTW), contralateral ACL rupture and simple knee value (SKV) at 12 months. Survival was assessed using Kaplan-Meier estimates and adjusted Cox regression.
RESULTS
Overall, 841 knees were analysed: 786 isolated ACLR and 55 ACLR + LMPR repair, with a median follow-up of 46.0 months. ACL graft rerupture occurred in 41 isolated ACLR patients and 5 ACLR + LMPR repair patients (5.2% vs. 9.1%; p = 0.216), with no significant difference in graft rerupture-free survival (log-rank p = 0.209). In adjusted Cox analysis, ACLR + LMPR repair was not independently associated with graft rerupture-free survival (hazard ratio [HR] 1.5; 95% confidence interval [CI] 0.6-3.9; p = 0.407), whereas professional athlete status increased rerupture risk (HR 2.8; 95% CI 1.3-6.1; p = 0.010). Contralateral ACL rupture, RTS, RTW and postoperative SKV were comparable between groups.
CONCLUSIONS
Concomitant all-inside LMPR repair during ACLR was not independently associated with decreased graft rerupture-free survival and showed comparable clinical outcomes to isolated ACLR at short- to mid-term follow-up.
LEVEL OF EVIDENCE
Level III, retrospective comparative cohort study.