IV.

Level IV, therapeutic case series.

Purpose Concomitant meniscus injuries in the anterior cruciate ligament (ACL) injuries have been suggested to exacerbate rotational laxity. However, the effect is supposed to be so small, if any, that some quantitative pivot-shift measurement is needed. The purpose of this prospective study was to determine the effect of meniscus tear on rotational laxity in ACL-deficient knees by an quantitative measurement. We hypothesized that a concomitant meniscus tear, especially a lateral one, would induce greater pivot-shift. Methods Fifty-seven unilateral ACL-injured patients (26 men and 31 women, mean age: 24±10 years) were included. The pivot-shift test was performed prior to ACL reconstruction while a quantitative evaluation using an electromagnetic system to determine tibial acceleration and a clinical grading according to the IKDC were performed. Meniscus injuries were diagnosed arthroscopically, and concomitant meniscus tear was confirmed in 32 knees. Chi-squared and Mann-Whitney U tests were used to assess the difference between knees with and without meniscus tear. A subgroup analysis was subsequently performed for the medial, bilateral, and lateral meniscus-torn groups compared with the meniscus-intact group, using the chi-squared test and analysis of variance. Statistical significance was defined at p<0.05.

This study suggests that simvastatin stimulated intrinsic healing of an avascular meniscus. The local administration of simvastatin is safe and inexpensive and seems to be a promising treatment of meniscal injuries.

Surgeons should consider a patient's age when performing ACL reconstruction with remnant preservation or ruptured tissue incorporation, as this can predict healing ability.