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Document Title: Yagishita-AJSM-Dec04.shtml
Article Title: Healing Potential of Meniscal Tears Without Repair in Knees With Anterior Cruciate Ligament Reconstruction
Authors: Kazuyoshi Yagishita, MD, PhD, Takeshi Muneta, MD, PhD, Takashi Ogiuchi, MD, Ichiro Sekiya, MD, PhD and Kenichi Shinomiya, MD, PhD
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: December 2004
Volume 32, pages 1953-1961
Keywords: Meniscal repair, ACL reconstruction, combined surgery, healing potential.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: Meniscal injuries very often occur in conjunction with ACL tearing. This is not surprising, since planting-and-twisting is a major cause of both injury types. This study concludes that although some stable types of tears can be left unattended to while the ACL is reconstructed, major tears involving the medial meniscus should be repaired (ideally via suturing). And, because knee surgery is an involved procedure, it makes sense to combine meniscal repair with the ACL reconstruction. The fact that a meniscal tear might worsen if left unrepaired also makes repair very appropriate.
ABSTRACT
Background: Few previous studies have documented the healing potential of meniscal tears that are left to heal without repair.
Purpose: To determine the healing rates of meniscal tears left without repair in knees with anterior cruciate ligament reconstruction.
Study Design: Prospective cohort study.
Methods: One hundred and ninety-two knees were evaluated at the time of anterior cruciate ligament reconstruction and repeat arthroscopy. The healing rates of 41 medial and 42 lateral torn menisci without repair were evaluated by the same 2 surgeons in an identical fashion.
Results: Of 41 medial torn menisci left without repair, 22 (56%) were considered completely healed, 3 (7%) were incompletely healed, 11 (24%) were unhealed, and 5 (10%) had expanded unhealed lesions. Of 42 lateral torn menisci, 31 (74%) were considered completely healed, 2 (5%) were incompletely healed, 6 (14%) were unhealed, and 3 (7%) had expanded unhealed lesions. The healing rate of a medial meniscal tear was length dependent and not related to reconstructed ligament stability.
Conclusions: Stable meniscal tears at the time of anterior cruciate ligament reconstruction possibly could be left in situ. However, longer medial meniscal tears are thought to require additional stabilizing procedures.
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