Comparison of anterior cruciate ligament reconstruction with and without concomitant meniscal repair: A prospective comparative study

Arya A, Kumar SD, Rajkumar V, Sudhan SR

Pdf Page Numbers :- 315-322

Ashish Arya¹, Dheepan Kumar S², Rajkumar V³ and Ram Sudhan S^4,*

¹Department of Orthopaedics, Kalpana Chawla Government Medical College, Model town, Karnal, Haryana 132001, India

²Department of Orthopaedics, Velammal Medical College Hospital, Madurai, Tamil Nadu 625009, India

³Department of Orthopaedics Govt. Medical College and Hospital, Omandurar Government Estate, Chennai -600002, India

⁴Department of Orthopaedics, PK DAS Institute of Medical Sciences – Hospital and Medical College, Vaniamkulam, Ottapalam, Kerala 679522, India

*Corresponding author: Dr. Ram Sudhan S, D'Ortho, DNB (Ortho), MNAMS, MIMSA. Assistant Professor, Department of Orthopaedics, PK DAS Institute of Medical Sciences – Hospital and Medical College, Vaniamkulam, Ottapalam, Kerala 679522, India. Email: sudhansubramaniam@gmail.com

Received 15 June 2023; Revised 6 September 2023; Accepted 14 September 2023; Published 22 September 2023

Citation: Arya A, Kumar SD, Rajkumar V, Sudhan SR. Comparison of anterior cruciate ligament reconstruction with and without concomitant meniscal repair: A prospective comparative study. J Med Sci Res. 2023; 11(4):315-322. DOI: http://dx.doi.org/10.17727/JMSR.2023/11-58

Copyright: © 2023 Arya A et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: The treatment of anterior cruciate ligament (ACL) injury includes ACL reconstruction (ACL-R) or ligament preservation, where the former is considered the gold standard. But in meniscal injury, though commonly followed is menisectomy, meniscal repair has gained popularity and success which necessitates the analysis of outcome between ACL-R + meniscal repair and ACL-R + menisectomy as clear consensus have not been established so far in deciding the better overall procedure with respect to function.

Methods: This is a prospective, comparative study done in 122 patients with ACL injury and medial/ lateral meniscus in south Indian population at a single center. Where meniscal repair (61) and menisectomy (partial/complete, n=61) with ACL-R were carried out and were evaluated pre-operatively, during the postoperative period at 6 weeks, 3 months, and 6 months of follow-up for function and compared. The primary outcome evaluated was pain and other symptoms like limping, giving way, swelling and locking were also noted and analysed using KOOS, IKDC and Lysholm scores.

Results: The mean difference in KOOS score in postoperative period, at 3 and 6months were significantly higher among the ACL-R + meniscal repair group than the ACL-R + meniscectomy group which is statistically significant. Moreover the median percentage change in IKDC and Lysholm scores from baseline to postoperative 3 and 6 months were significantly higher in ACL-R + meniscal repair group than the other.

Conclusion: The meniscal repair with ACL-R has a lower failure rate and shows better functional outcomes than the other group which underwent ACL-R and meniscectomy.

Keywords: anterior cruciate ligament reconstruction; ACL-R; meniscectomy; meniscal repair; meniscal tear