BACKGROUND: Previous research suggests that a substantial percentage of meniscal repairs fail, resulting in a subsequent meniscectomy. Risk factors for failure have been investigated using small cohorts, providing ambiguous results. PURPOSE: To measure the frequency of and elucidate risk factors for subsequent meniscectomies after meniscal repair using a large study population from multiple surgical centers. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 9529 patients who underwent 9609 outpatient meniscal repairs between 2003 and 2010 were identified from a statewide database of all ambulatory surgery in New York. Patients who subsequently underwent a meniscectomy were then identified. A Cox regression analysis was used to calculate the hazard ratio and 95% confidence intervals. The model included patient age, sex, comorbidities, concomitant arthroscopic procedures, laterality of the meniscus, and surgeon's yearly meniscal repair volume. RESULTS: The overall frequency of subsequent meniscectomies was 8.9%. Patients were at a decreased risk for subsequent meniscectomies if they underwent a concomitant anterior cruciate ligament (ACL) reconstruction (P < .001). Patients undergoing isolated meniscal repairs (without concomitant ACL reconstruction) were at a decreased risk if they were older (P < .001), had a lateral meniscal injury (P = .002), or were operated on by a surgeon with a higher annual meniscal repair volume (>24 cases/year; P < .001). CONCLUSION: A meniscectomy after meniscal repair is performed infrequently, supporting the notion that repairing a meniscus is a safe and effective procedure in the long term. The risk for undergoing subsequent meniscectomies is decreased in patients undergoing a concomitant ACL reconstruction, in cases of isolated meniscal repairs for patients of older age, and in patients undergoing meniscal repair by surgeons with a high case volume.
BACKGROUND: Previous research suggests that a substantial percentage of meniscal repairs fail, resulting in a subsequent meniscectomy. Risk factors for failure have been investigated using small cohorts, providing ambiguous results. PURPOSE: To measure the frequency of and elucidate risk factors for subsequent meniscectomies after meniscal repair using a large study population from multiple surgical centers. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 9529 patients who underwent 9609 outpatient meniscal repairs between 2003 and 2010 were identified from a statewide database of all ambulatory surgery in New York. Patients who subsequently underwent a meniscectomy were then identified. A Cox regression analysis was used to calculate the hazard ratio and 95% confidence intervals. The model included patient age, sex, comorbidities, concomitant arthroscopic procedures, laterality of the meniscus, and surgeon's yearly meniscal repair volume. RESULTS: The overall frequency of subsequent meniscectomies was 8.9%. Patients were at a decreased risk for subsequent meniscectomies if they underwent a concomitant anterior cruciate ligament (ACL) reconstruction (P < .001). Patients undergoing isolated meniscal repairs (without concomitant ACL reconstruction) were at a decreased risk if they were older (P < .001), had a lateral meniscal injury (P = .002), or were operated on by a surgeon with a higher annual meniscal repair volume (>24 cases/year; P < .001). CONCLUSION: A meniscectomy after meniscal repair is performed infrequently, supporting the notion that repairing a meniscus is a safe and effective procedure in the long term. The risk for undergoing subsequent meniscectomies is decreased in patients undergoing a concomitant ACL reconstruction, in cases of isolated meniscal repairs for patients of older age, and in patients undergoing meniscal repair by surgeons with a high case volume.
Authors: Ryan Blackwell; Laura C Schmitt; David C Flanigan; Robert A Magnussen Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-02-01 Impact factor: 4.342
Authors: G Filardo; E Kon; F Perdisa; A Sessa; A Di Martino; M Busacca; S Zaffagnini; M Marcacci Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-07-09 Impact factor: 4.342
Authors: Justin W Griffin; Michael M Hadeed; Brian C Werner; David R Diduch; Eric W Carson; Mark D Miller Journal: Clin Orthop Relat Res Date: 2015-02-06 Impact factor: 4.176
Authors: Kyle R Duchman; Robert W Westermann; Kurt P Spindler; Emily K Reinke; Laura J Huston; Annunziato Amendola; Brian R Wolf Journal: Am J Sports Med Date: 2015-10-01 Impact factor: 6.202
Authors: Robinetta Hudson; Amy Richmond; Belinda Sanchez; Valerie Stevenson; Russell T Baker; James May; Alan Nasypany; Don Reordan Journal: Int J Sports Phys Ther Date: 2016-08
Authors: Robinetta Hudson; Amy Richmond; Belinda Sanchez; Valerie Stevenson; Russell T Baker; James May; Alan Nasypany; Don Reordan Journal: J Man Manip Ther Date: 2018-04-04