Combined Meniscus Repair and Anterior Cruciate Ligament Reconstruction

Rodriguez, Ariel N.; LaPrade, Robert F.; Geeslin, Andrew G.

doi:10.1016/j.arthro.2022.01.003

Cited by 23 publications

(18 citation statements)

References 15 publications

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“…This is a key aspect, since meniscal tears represent one of the most common injuries in orthopaedics, with a mean annual incidence of 60−70 per 100.000 [23], and since patients undergoing ACL reconstruction have been reported to have a meniscus tear incidence from 55% up to nearly 80% [24][25][26][27][28]. Meniscal lesions should therefore be carefully considered when performing ACL reconstruction surgery to restore knee stability [29][30][31][32]. In fact, while meniscectomy can increase the femoro-tibial contact stress and anterior tibial translation in ACL-deficient knees, meniscal repair showed to increase anteromedial knee laxity [8,33].…”

Section: Discussionmentioning

confidence: 99%

Medial meniscal lesions increase antero‐posterior laxity in knees with anterior cruciate ligament injury

Franceschini,

Reale,

Boffa

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to quantify the impact of concomitant meniscal lesions on knee laxity using a triaxial accelerometer in a large population of patients affected by anterior cruciate ligament (ACL) injury.MethodsA total of 326 consecutive patients (261 men and 65 women, mean age 31.3 ± 11.3) undergoing primary ACL reconstruction, were preoperatively evaluated through Lachman and pivot shift tests using a triaxial accelerometer to quantify knee laxity. An analysis based on the presence of meniscal tears assessed during surgery was performed to evaluate the impact of meniscal lesions on knee laxity.ResultsThe anterior tibial translation (Lachman test) presented significantly higher values in patients with medial meniscal lesions (7.3 ± 1.7 mm, p = 0.049) and both medial and lateral meniscal lesions (7.7 ± 1.6 mm, p = 0.001) compared to patients without concomitant meniscal lesions (6.7 ± 1.3 mm). Moreover, patients with both medial and lateral meniscal lesions presented significantly higher values of anterior tibial translation compared to patients with lateral meniscal lesions (p = 0.049). No statistically significant differences were found between the groups in terms of tibial acceleration (pivot shift test).ConclusionThis study demonstrated that the contribution of concomitant meniscal lesions to knee laxity can be objectively quantified using a triaxial accelerometer in ACL‐injured knees. In particular, medial meniscus lesions, alone or in association with lateral meniscus lesions, determine a significant increase of the anterior tibial translation compared to knees without meniscus tears.Level of EvidenceLevel IV.

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Section: Discussionmentioning

confidence: 99%

Medial meniscal lesions increase antero‐posterior laxity in knees with anterior cruciate ligament injury

Franceschini,

Reale,

Boffa

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…As we all know, since PCL plays an important role in maintaining joint stability, its fracture will affect knee joint stability and accelerate damage to the knee meniscus and articular cartilage. [20] Therefore, timely PCL reconstruction can restore the stability of the injured knee joint and avoid secondary injuries caused by joint instability. At the same time, simple PCL fracture is relatively rare in clinical cases, most of which are complicated with meniscus tear or articular cartilage injury.…”

Section: Discussionmentioning

confidence: 99%

Differences in postoperative knee joint function and prognostic quality of life in patients undergoing posterior cruciate ligament reconstruction at different surgical timing under enhanced recovery after surgery

Jin

2023

Medicine

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To explore the differences in postoperative knee joint function and prognostic quality of life in patients undergoing posterior cruciate ligament (PCL) reconstruction at different timing of surgery under the enhanced recovery after surgery (ERAS) protocol. A total of 266 cases of PCL injury admitted to our hospital between March 2019 and October 2022 were included in this retrospective study and divided them into a short-term group (147 cases with PCL reconstruction completed within 3 weeks after injury) and a long-term group (119 cases with PCL reconstruction performed 3 weeks after injury) according to the timing of surgery after injury. All patients received ERAS care during treatment. The operation time, intraoperative blood loss, and incision length of both cohorts were counted to evaluate the clinical efficacy. Perioperative patients were assessed by the Visual Analogue Scale for pain severity. The pre- and post-operative knee function and knee joint range of motion were assessed by the International Knee Documentation Committee and Lysholm Knee Scoring Scale. Furthermore, the complication rate was counted and the quality of life was evaluated by the Short-Form 36 Item Health Survey. Patients were also assessed for their psychological states using the Self-rating Anxiety/Depression Scale and their satisfaction with care. The 2 groups showed similar operation time, intraoperative blood loss, incision length, overall response rate, and Visual Analogue Scale (P > .05), but the short-term group had higher knee range of motion and scores of International Knee Documentation Committee and Lysholm Scale than the long-term group (P < .05). A similar complication rate was also determined in the 2 groups (P > .05), but the Short-Form 36 Item Health Survey scores were significantly higher in the short-term group (P < .05). Self-rating Anxiety Scale and Self-rating Depression Scale in both groups decreased after treatment (P < .05), and no statistical difference was determined in nursing satisfaction (P = 198). PCL reconstruction within 3 weeks after PCL injury is more conducive to the recovery of patients’ knee joint function, and the ERAS protocol can more effectively improve the therapeutic effect of patients.

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“…The reduction and xation of the tibial insertion fracture of the anterior cruciate ligament was performed with arthroscopic fracture reduction and Orthocord line binding xation. Meniscal repair referred to the method used by Rodriguez et al 10 The medial or lateral collateral ligament tears were treated with anchor suture xation. After operation, the affected limb was xed in the straight position of the brace, and the Segond fractures were not treated.…”

Section: Surgical Techniquementioning

confidence: 99%

Effects of Segond fracture and associated injuries on knee stability

Ruan

liu

et al. 2022

Preprint

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Objective: To investigate the effects of Segond fracture and associated injuries on knee stability. Methods: Retrospective analysis of 35 cases of Segond fracture, allpatients had anterior cruciate ligament rupture (100%), including 6 patients (17.1%) with avulsion fracture of tibia intercondylar eminence. There were 8 cases (22.9%) with medial collateral ligament injury. There were 5 cases (14.3%) with lateral collateral ligament injury. There were 20 cases (57.1%) with combined meniscus injury, 5cases (14.3%) with both medial and lateral meniscus injury, 3 cases (8.6%) with only medial meniscus injury, and 12cases (34.3%) with only lateral meniscus injury. All 35 patients underwent surgical treatment, including 35 cases of ligament reconstruction, 6 cases of intercondylar eminence fracture fixation, and 20 cases of meniscus repair. To compare the function and stability of knee joint before operation and 2 years after operation. Results: The Lysholm score for knee joint function on admission was (43.9±5.3) and the IKDC score was (36.1±3.9). All 35 patients were followed up for 24-36 months. X-rays showed that the Segond fractures healed 3 months after surgery. The anterior drawer test, Lachman test, McMurray test, and Lateral stress test were all negative at the last follow-up. 5 patients with lateral meniscus injury had 1 grade pivot shift at the last follow-up. The Lysholm score was (91.7±3.6), and the difference was statistically significant as compared with that before surgery (P<0.05). The IKDC score was (89.0±1.7), and the difference was statistically significant as compared with that before surgery (P<0.05). Conclusion: The indicative effect of Segond fracture on timely detection of combined injuries in the knee joint cannot be ignored. In addition to repairing the intra-articular injuries, more attention should be paid to the anterolateral structural stability of the knee joint. For Segond fracture patients with higher pivot shift grade may have residual axial migration after surgery, so ALL reconstruction surgery may be considered.

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Combined Meniscus Repair and Anterior Cruciate Ligament Reconstruction

Cited by 23 publications

References 15 publications

Medial meniscal lesions increase antero‐posterior laxity in knees with anterior cruciate ligament injury

Medial meniscal lesions increase antero‐posterior laxity in knees with anterior cruciate ligament injury

Differences in postoperative knee joint function and prognostic quality of life in patients undergoing posterior cruciate ligament reconstruction at different surgical timing under enhanced recovery after surgery

Effects of Segond fracture and associated injuries on knee stability

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