Trends in the surgical treatment of meniscal tears in patients with and without concurrent anterior cruciate ligament tears

DeFroda, Steven F.; Yang, Daniel S.; Donnelly, Joseph C.; Bokshan, Steven L.; Owens, Brett D.; Daniels, Alan H.

doi:10.1080/00913847.2019.1685363

Cited by 21 publications

(16 citation statements)

References 20 publications

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“…18,19,49,60 These contemporary changes are reflected in the current study, which found increases in the proportion of meniscal repair with concomitant ACLR. 4,16,48 In a study by Abrams et al 4 between 2005 and 2011, the authors found a 48.3% overall increase in the number of meniscal repairs performed during ACLR; however, the overall incidence was not significantly changed. In a similar study by DeFroda et al 16 between 2010 and 2015, the number of ACLRs with concomitant meniscectomy was 2.9 times that with concomitant meniscal repairs; however, the incidence of meniscectomy decreased while the incidence of meniscal repair remained constant.…”

Section: Discussionmentioning

confidence: 99%

“…The chondroprotective effect of performing an arthroscopic meniscal repair, instead of a partial meniscectomy, with a concomitant ACL reconstruction (ACLR) has been demonstrated in multiple studies. 5 , 14 , 16 , 20 , 48 , 52 , 62 Even with restoration of knee stability, meniscectomy (when performed before, during, or after ACL surgery) has been shown to accelerate degenerative joint changes. 14 , 20 , 30 , 35 , 52 Therefore, the importance of meniscal preservation in ACLR is increasingly recognized.…”

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confidence: 99%

“…Database publications between 2004 and 2015 have displayed trends of decreased meniscectomy rates with either stable or increasing meniscal repair rates. 4 , 16 , 48 These publications concluded that surgeons were performing more meniscal repairs, particularly on younger patients and those with lower body mass index (BMI). Evolving evidence and surgical procedures in favor of meniscal preservation has led to a diversification of surgical candidates undergoing meniscal repair.…”

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confidence: 99%

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Recent Trends in Concomitant Meniscal Procedures During Anterior Cruciate Ligament Reconstruction

Partan

Iturriaga

Cohn

2021

Orthopaedic Journal of Sports Medicine

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Background: The chondroprotective effect and secondary stabilizing role of the meniscus has been well-established. Meniscal preservation during anterior cruciate ligament reconstruction (ACLR) has been advocated in the literature and supported by advancements in surgical techniques. Purpose: To examine the recent trends in concomitant partial meniscectomy and meniscal repair procedures with ACLR. Study Design: Descriptive epidemiological study. Methods: Patients who underwent arthroscopic meniscectomy (Current Procedural Terminology [CPT] codes 29880, 29881), meniscal repair (CPT codes 29882, 29883), and ACLR (CPT code 29888) between 2010 and 2018 were identified using the National Surgical Quality Improvement Program database. We calculated the proportion of patients who underwent each surgery type, stratified by year and by patient age and body mass index (BMI) groups. The Cochran-Armitage test for trend was used to analyze yearly proportions of concomitant meniscal surgery types. Results: During the 9-year study period, 22,760 patients underwent either isolated ACLR (n = 10,562) or ACLR with concomitant meniscal surgery (either meniscectomy [n = 8931] or meniscal repair [n = 3267]). There was a gradual decrease in the proportion of meniscectomies (from 80.8% of concomitant procedures in 2010 to 63.8% in 2018), while the proportion of meniscal repairs almost doubled (from 19.2% in 2010 to 36.2% in 2018) (trend, P < .001). ACLR with meniscal repair increased in patients aged 35 to 44 years and 45 to 54 years (trend, P = .027) between 2010 and 2018; at the same time, the proportion of normal weight patients decreased by 17.7%, the proportion of overweight patients increased by 13.2%, and increases were seen in BMI groups corresponding to obesity classes 1 to 3 (trend, P < .001). In 2010, the average BMI of patients undergoing ACLR with meniscectomy versus meniscal repair differed by 2 ( P = .004), but by 2018 the difference was nonsignificant (28.83 ± 5.80 vs 28.53 ± 5.73; P = .113). Conclusion: Between 2010 and 2018, there was an upward trend in the proportion of meniscal repairs performed during ACLR, with notable increases in the proportion of repairs being performed on older, overweight, and obese patients.

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Section: Discussionmentioning

confidence: 99%

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Recent Trends in Concomitant Meniscal Procedures During Anterior Cruciate Ligament Reconstruction

Partan

Iturriaga

Cohn

2021

Orthopaedic Journal of Sports Medicine

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“…From private insurer databases alone, more than 85,000 meniscus procedures were performed within a 5-year window. 1 Clearly, meniscal injuries represent a significant volume in orthopaedic surgery, and our management decisions continue to be shaped by various biomechanical and clinical analyses. Many of us start practice trying to repair as many menisci as possible because we feel we need to give them a chance to heal, but in reality, more than 20% may go on to meniscectomy.…”

Section: See Related Article On Page 3001mentioning

confidence: 99%

Editorial Commentary: Moving the Needle: Traditional Inside-Out Meniscal Repair Has Advantages Over All-Inside Repair

Yanke

Dandu

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“… 1 Recent studies have shown a decrease in the number of the meniscectomies performed in the United States. 2 , 3 Meniscectomy was the treatment that prevailed for decades. Despite providing good clinical results in the short term, it showed an intimate relationship with the development of osteoarthritis in the medium and long term.…”

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Outside-in Continuous Meniscal Suture Technique of the Knee

Faria

Pavão

Pádua

et al. 2020

Arthroscopy Techniques

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The meniscus is largely responsible for the health and longevity of the knee. It has diverse functions, being fundamental in load absorption and distribution and even in joint stability. To preserve meniscal functions and prevent the occurrence of osteoarthritis after meniscectomy, several meniscal repair techniques have been developed. To perform meniscal repair in anterior horn, the outside-in technique is the most used. There are few devices for performing them, with most of the surgical techniques described using needles. Our group uses a device capable of performing meniscal repair in different ways. Our objective is to describe a continuous outside-in meniscal repair technique, especially indicated for anterior horn and meniscus body tears, with the “Meniscus 4-All suture device.” The continuous outside-in meniscal suture technique using this device is easy to perform, inexpensive, fast, and reproducible, minimizing the risk of soft-tissue entrapment. In addition, it allows the surgeon to perform meniscal repair in the posterior horn in extensive injuries with the same repair device, just switching to inside-out technique.

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Trends in the surgical treatment of meniscal tears in patients with and without concurrent anterior cruciate ligament tears

Cited by 21 publications

References 20 publications

Recent Trends in Concomitant Meniscal Procedures During Anterior Cruciate Ligament Reconstruction

Recent Trends in Concomitant Meniscal Procedures During Anterior Cruciate Ligament Reconstruction

Editorial Commentary: Moving the Needle: Traditional Inside-Out Meniscal Repair Has Advantages Over All-Inside Repair

Outside-in Continuous Meniscal Suture Technique of the Knee

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