The Impact of Meniscal Tear Type and Surgical Treatment on Quadriceps Strength: A Study of Adolescent Patients Post Anterior Cruciate Ligament Reconstruction

Abstract

Background: Treatment of meniscal injuries at the time of anterior cruciate ligament reconstruction (ACLR) can result in restrictions on weightbearing and range of motion in the early rehabilitative phases. What is unknown is the effect of (1) meniscal tear type and location at the time of anterior cruciate ligament injury and (2) meniscal treatment at the time of ACLR on quadriceps strength in adolescents during the late rehabilitative phase. Hypothesis: Meniscal tears involving the root and requiring repair would adversely affect quadriceps strength at 6 to 9 months postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent ACLR at 1 of 2 research sites between 2013 and 2021 were identified. Adolescent participants were included if they were between the ages of 12 and 20 years at the time of assessment and had undergone primary unilateral ACLR in the previous 6 to 9 months. Participants were subgrouped by meniscal tear type (no tear, nonroot tear, root tear) and meniscal treatment at the time of ACLR (no treatment, meniscectomy, meniscal repair), which were confirmed via chart review. Isokinetic strength testing occurred at 60 deg/s, and quadriceps strength and quadriceps strength limb symmetry index were compared between the meniscal tear type and meniscal procedure subgroups using analysis of covariance while controlling for the effects of age, sex, and ACLR graft source. Results: An overall 236 patients were included in this analysis (109 male, 127 female; mean ± SD age, 16.0 ± 1.9 years). There were no significant differences in ACLR limb quadriceps strength based on meniscal tear type (P = .61) or meniscal procedure at the time of ACLR (P = .61), after controlling for age, biological sex, and ACLR graft source. Similarly, quadriceps strength limb symmetry index did not differ by meniscal tear type (P = .38) or meniscal procedure at the time of ACLR (P = .40). Conclusion: Meniscal tear type and treatment at the time of ACLR did not affect quadriceps strength or quadriceps strength symmetry in adolescents 6 to 9 months after ACLR.