Meniscal Repairs Performed With Posterior Cruciate Ligament Reconstruction Are Associated With Lower Failure Rates Than Isolated Repairs.
TL;DR
MRs performed concomitantly with PCLR were associated with significantly lower failure rates compared with isolated MRs, with an effect size comparable to that of ACLR + MR.
Abstract
Purpose
To assess the incidence of meniscal repair (MR) failure after posterior cruciate ligament reconstruction (PCLR) + MR compared with MR alone.
Methods
Patients undergoing isolated PCLR + MR or MR alone were identified from a large insurance database (PearlDiver). A cohort of isolated ACLR + MR was also developed to provide reference data. Demographic, surgical, and comorbidity data were collected and controlled for. The primary outcome was ipsilateral repair failure defined as revision meniscal surgery at 2 years. Secondary outcomes included ipsilateral revision or conversion arthroplasty (RoA). Time-to-event analyses were used to compare outcomes between groups.
Results
There were 21,358 patients (0.9% PCLR + MR, 99.1% MR alone) with a mean follow-up of 3.1 ± 2.1 years. Compared with patients who underwent MR alone, patients who underwent PCLR + MR had significantly lower meniscal failure (unadjusted: 4.1% vs 8.4%, P = .04; adjusted hazard ratio [HR]: 0.41 [0.20-0.82], P = .01) and RoA (unadjusted: 4.1% vs 8.7%, P = .03; adjusted HR: 0.40 [0.20-0.80], P = .01) rates at 2 years. For reference, compared with MR alone, a similar improvement in failure rates was seen with concomitant ACLR + MR (unadjusted: 5.6% vs 8.4%, P < .001; adjusted HR: 0.61 [0.57-0.66], P < .001), whereas there was no difference between PCLR + MR and ACLR + MR (unadjusted: 4.1% vs 5.6%, P = .40; adjusted HR: 0.64 [0.32-1.29], P = .21).
Conclusions
MRs performed concomitantly with PCLR were associated with significantly lower failure rates compared with isolated MRs, with an effect size comparable to that of ACLR + MR. LEVEL OF EVIDENCE Level III, retrospective comparative cohort study.