Only 7.7 percent of tears required reoperation; risk factors include medial tears, longer tears
MONDAY, July 13, 2015 (HealthDay News) — For patients undergoing anterior cruciate ligament (ACL) surgery, treating additional meniscus tears may not be necessary, according to a study presented at the annual meeting of the American Orthopaedic Society for Sports Medicine, held from July 9 to 12 in Orlando, Fla.
Kyle R. Duchman, M.D., from the University of Iowa Hospitals and Clinics in Iowa City, and colleagues determined the rate of subsequent reoperation and clinical outcome of meniscal tears left in situ without treatment at the time of ACL reconstruction. Patients with 1,440 primary ACL reconstructions were identified from a multicenter study group between 2002 and 2004, and were followed for a minimum of six years.
The researchers found that 66.3 percent of patients had concomitant meniscal tears, of whom 15.3 percent (143 patients) had meniscal tears left in situ at the time of surgery. For patients with lateral and medial tears left untreated, 97.8 and 94.4 percent, respectively, required no reoperation. Compared with lateral meniscus tears, reoperation was performed more frequently for medial meniscal tears (17.6 versus 4.3 percent; P = 0.048). Only 16 tears (7.7 percent) required reoperation. Risk factors for reoperation included medial meniscal tears and tears ≥10 mm in length.
“As surgeons, we want to avoid too much intervention on a patient’s knee when good outcomes can be expected,” Duchman said in a statement. “While large, unstable meniscus tears may need treatment at time of ACL surgery, this study confirms the smaller, stable tears can be left alone.”
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