Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction
Abstract Background Concomitant lateral meniscal (LM) injuries are common in acute anterior cruciate ligament (ACL) ruptures. However, the effect of addressing these injuries with various treatment methods during primary ACL reconstruction (ACLR) on patient-reported outcomes (PROs) is unknown. There...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-09-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-06867-z |
| _version_ | 1797454141435412480 |
|---|---|
| author | Janina Kaarre Zachary J. Herman Fabian Persson Jonas Olsson Wållgren Eduard Alentorn-Geli Eric Hamrin Senorski Volker Musahl Kristian Samuelsson |
| author_facet | Janina Kaarre Zachary J. Herman Fabian Persson Jonas Olsson Wållgren Eduard Alentorn-Geli Eric Hamrin Senorski Volker Musahl Kristian Samuelsson |
| author_sort | Janina Kaarre |
| collection | DOAJ |
| description | Abstract Background Concomitant lateral meniscal (LM) injuries are common in acute anterior cruciate ligament (ACL) ruptures. However, the effect of addressing these injuries with various treatment methods during primary ACL reconstruction (ACLR) on patient-reported outcomes (PROs) is unknown. Therefore, the purpose of this study was to compare postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) at 2-, 5-, and 10-years after isolated primary ACLR to primary ACLR with various treatment methods to address concomitant LM injury. Methods This study was based on data from the Swedish National Knee Ligament Registry. Patients ≥ 15 years with data on postoperative KOOS who underwent primary ACLR between the years 2005 and 2018 were included in this study. The study population was divided into five groups: 1) Isolated ACLR, 2) ACLR + LM repair, 3) ACLR + LM resection, 4) ACLR + LM injury left in situ, and 5) ACLR + LM repair + LM resection. Patients with concomitant medial meniscal or other surgically treated ligament injuries were excluded. Results Of 31,819 included patients, 24% had LM injury. After post hoc comparisons, significantly lower scores were found for the KOOS Symptoms subscale in ACLR + LM repair group compared to isolated ACLR (76.0 vs 78.3, p = 0.0097) and ACLR + LM injury left in situ groups (76.0 vs 78.3, p = 0.041) at 2-year follow-up. However, at 10-year follow-up, no differences were found between ACLR + LM repair and isolated ACLR, but ACLR + LM resection resulted in significantly lower KOOS Symptoms scores compared to isolated ACLR (80.4 vs 82.3, p = 0.041). Conclusion The results of this study suggest that LM injury during ACLR is associated with lower KOOS scores, particularly in the Symptoms subscale, at short- and long-term follow-up. However, this finding falls below minimal clinical important difference and therefore may not be clinically relevant. Level of Evidence III. |
| first_indexed | 2024-03-09T15:32:59Z |
| format | Article |
| id | doaj.art-3cd11b5c430848c2bd6858336ff4db2a |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-09T15:32:59Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3cd11b5c430848c2bd6858336ff4db2a2023-11-26T12:07:51ZengBMCBMC Musculoskeletal Disorders1471-24742023-09-0124111210.1186/s12891-023-06867-zDifferences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstructionJanina Kaarre0Zachary J. Herman1Fabian Persson2Jonas Olsson Wållgren3Eduard Alentorn-Geli4Eric Hamrin Senorski5Volker Musahl6Kristian Samuelsson7Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of GothenburgDepartment of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh Medical CenterDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of GothenburgDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of GothenburgInstituto Cugat, Hospital Quironsalud BarcelonaSahlgrenska Sports Medicine CenterDepartment of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh Medical CenterDepartment of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy University of GothenburgAbstract Background Concomitant lateral meniscal (LM) injuries are common in acute anterior cruciate ligament (ACL) ruptures. However, the effect of addressing these injuries with various treatment methods during primary ACL reconstruction (ACLR) on patient-reported outcomes (PROs) is unknown. Therefore, the purpose of this study was to compare postoperative Knee injury and Osteoarthritis Outcome Score (KOOS) at 2-, 5-, and 10-years after isolated primary ACLR to primary ACLR with various treatment methods to address concomitant LM injury. Methods This study was based on data from the Swedish National Knee Ligament Registry. Patients ≥ 15 years with data on postoperative KOOS who underwent primary ACLR between the years 2005 and 2018 were included in this study. The study population was divided into five groups: 1) Isolated ACLR, 2) ACLR + LM repair, 3) ACLR + LM resection, 4) ACLR + LM injury left in situ, and 5) ACLR + LM repair + LM resection. Patients with concomitant medial meniscal or other surgically treated ligament injuries were excluded. Results Of 31,819 included patients, 24% had LM injury. After post hoc comparisons, significantly lower scores were found for the KOOS Symptoms subscale in ACLR + LM repair group compared to isolated ACLR (76.0 vs 78.3, p = 0.0097) and ACLR + LM injury left in situ groups (76.0 vs 78.3, p = 0.041) at 2-year follow-up. However, at 10-year follow-up, no differences were found between ACLR + LM repair and isolated ACLR, but ACLR + LM resection resulted in significantly lower KOOS Symptoms scores compared to isolated ACLR (80.4 vs 82.3, p = 0.041). Conclusion The results of this study suggest that LM injury during ACLR is associated with lower KOOS scores, particularly in the Symptoms subscale, at short- and long-term follow-up. However, this finding falls below minimal clinical important difference and therefore may not be clinically relevant. Level of Evidence III.https://doi.org/10.1186/s12891-023-06867-zLateral meniscal repairLateral meniscal resectionKOOS |
| spellingShingle | Janina Kaarre Zachary J. Herman Fabian Persson Jonas Olsson Wållgren Eduard Alentorn-Geli Eric Hamrin Senorski Volker Musahl Kristian Samuelsson Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction BMC Musculoskeletal Disorders Lateral meniscal repair Lateral meniscal resection KOOS |
| title | Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction |
| title_full | Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction |
| title_fullStr | Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction |
| title_full_unstemmed | Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction |
| title_short | Differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary ACL reconstruction |
| title_sort | differences in postoperative knee function based on concomitant treatment of lateral meniscal injury in the setting of primary acl reconstruction |
| topic | Lateral meniscal repair Lateral meniscal resection KOOS |
| url | https://doi.org/10.1186/s12891-023-06867-z |
| work_keys_str_mv | AT janinakaarre differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT zacharyjherman differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT fabianpersson differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT jonasolssonwallgren differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT eduardalentorngeli differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT erichamrinsenorski differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT volkermusahl differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction AT kristiansamuelsson differencesinpostoperativekneefunctionbasedonconcomitanttreatmentoflateralmeniscalinjuryinthesettingofprimaryaclreconstruction |