Résultats de la réparation des lésions de la racine postérieure du ménisque latéral combinée à une reconstruction du ligament croisé antérieur après un suivi d’au moins deux ans

Abstract

The purpose of this study was to review outcomes of lateral meniscus posterior root tear (LMPRT) repair at a minimum follow-up of two years. It was hypothesized that repairing LMPRT would result in low surgical revision rate with good control over knee laxity and satisfying objective and subjective scores. This was a retrospective study analysing prospectively collected data. All patients who underwent primary ACL reconstruction from March 2015 to August 2018, performed by two surgeons (blinded), were considered for study eligibility. Clinical evaluations were performed at 3, 6,12 and 24 months. Patients were assessed pre- and postoperatively with the objective and subjective International Knee Documentation Committee (IKDC) evaluation form, Lysholm score and Tegner Activity Scale (TAS). Complications and reinterventions were also recorded. The final study population comprised 99 LMPRT repair. Ten (10.1%) patients underwent ipsilateral reoperation at a mean follow-up of 42 months, for a total of 11 procedures. There was one graft failure with concomitant LMPRT at 25 months follow-up due to a high risk sport trauma in a professional athlete. Postoperative side-to-side laxity significantly decreased at last follow-up with a mean of 0.6 ± 0.7 mm (p < 0.0001). The mean preoperative IKDC subjective score was 56.2 ± 13.9 and increased to 86.9 ± 7.6 postoperatively (p < 0.0001). Lysholm score was 61.6 ± 13.1 before surgery and 90.7 ± 6.7 after surgery (p < 0.0001). Preoperative mean TAS was 7.1 ± 1.1 and decreased to 6.6 ± 1.3 postoperatively (p < 0.006). Arthroscopic healing status was obtained for the ten patients who underwent reoperation. 9 of them (90%) had arthroscopic evidence of a fully healed LMPRT. One of them had not healed completely and required arthroscopic resection. LMPRT occurs concomitantly to ACL injury in 6 to 12% of cases and repair should be performed systematically. This is supported by excellent post-operative results after LMPRT repair at a minimum follow-up of 2 years.