Root avulsion and para-root tear of the posterolateral meniscus: repair versus untreated

Abstract

Background: This study aimed to assess the outcomes of repairing posterolateral meniscal (PLM) root avulsion and para-root tear in association with anterior cruciate ligament (ACL) reconstruction and compare with those whose PLM tear was left untreated. Methods: Patients with PLM root avulsion or para-root tear accompanying ACL tear were evaluated for eligibility. Group A was composed of patients whose ACL tears were reconstructed without any lateral meniscal repair (33 patients) from 2006-2009. From 2009-2012, patients had ACL reconstruction and additional PLM repair (group B: 40 patients). Both groups were evaluated for knee stability (Lachman test), return to previous level of sports activity, subjective International Knee Documentation Committee form (S-IKDC) and Lysholm knee scores (LKS). Results: Functional results (IKDS and LKS) at 12 and 24-month follow-up were similar between the two groups (all P>0.05). Eight patients (24%) in group A, and two patients (5%) in group B were unable to achieve the previous sports activity level (P=0.036). Return to previous sports activity level was significantly better in group B. Short-term (34.5 mo) and mid-term (73.5 mo) functional results of group A patients were compared, and it was demonstrated that IKDC (84.5±4) and LKS (87.7±3) scores were decreased significantly (P<0.0001). Conclusions: Functional outcomes of repairing PLM root avulsion and para-root tear with those whose PLM tear was left untreated are similar in short-term follow-up; however, as the time passes, the sports activity level and mid-term subjective outcomes may worsen in patients whose PLM tear was left untreated.