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J Knee Surg 2023; 36(13): 1341-1348
DOI: 10.1055/s-0042-1757594
Original Article

Concomitant Lateral Meniscus Tear is Associated with Residual Rotatory Knee Instability 1 Year after Anterior Cruciate Ligament Reconstruction: Case-cohort Study

Daisuke Chiba 
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Yuji Yamamoto
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Yuka Kimura
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Shizuka Sasaki
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Eiji Sasaki
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Shohei Yamauchi
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Eiichi Tsuda
2   Department of Rehabilitation Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
,
Yasuyuki Ishibashi
1   Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Aomori, Japan
› Author Affiliations Funding None.
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Abstract

Lateral meniscus tear (LMT) accompanied by anterior cruciate ligament (ACL) injuries has been reported to provoke rotatory instability of the affected knee joint. Unfortunately, these previous papers did not determine whether LMT-derived rotatory knee instability is residual because only preoperative or time zero data exists. This study aimed to longitudinally investigate how the prevalence of comorbid LMT is associated with residual rotatory knee instability (RKI) 1 year after ACL reconstruction (ACLR). A total of 327 patients who underwent double-bundle ACLR (average age: 23.4 years, body mass index: 23.5 kg/m2, 215 females). The patients were divided into three groups based on arthroscopy: 1) intact lateral meniscus (LM); 2) unrepaired LMT; 3) repaired LMT. At the 1-year follow-up, the pivot-shift test was performed. The prevalence of RKI, determined according to IKDC grades (grade ≥1 denoted RKI), was compared with chi-square or Fisher's exact tests. Thirty-eight patients (11.6%) had RKI; 203 subjects (62.1%) showed LMT, and 124 patients were diagnosed with an intact LM. Out of the 203 patients, 79 (38.9%) underwent LM repair. RKI was more prevalent in the LMT group than in the intact group (13.8% versus 8.1%, p = 0.117; Odds ratio: 1.499 [95%CI: 0.864 - 2.600]). In addition, the prevalence of RKI was significantly higher in the LM-repair group than in the intact-LM group (17.7% versus 8.1%, p = 0.038; Odds Ratio: 2.455 [95%CI: 1.032 - 5.842]). Medial meniscus tear (MMT) was detected in 113 patients (34.6%); RKI prevalence was not statistically different between the intact-MM group and the MMT group (12.2% versus 10.6%, p = 0.681). The current cohort study clarified that LMT comorbid with ACL injury was longitudinally associated with increased RKI prevalence 1 year after ACLR. Therefore, patients who underwent both ACLR and LM repair demonstrated a significantly higher prevalence of residual RKI.

Keywords

anterior cruciate ligament - lateral meniscus - rotatory knee instability - meniscus repair

Ethical Approval

The ethics committee of Hirosaki University Hospital and Hirosaki University Graduate School of Medicine approved the study design.


Availability of Data and Materials

The current data are not available to the public.


Patient Consent

The authors have acquired the consent of all participants to participate in this study.




Publication History

Received: 06 October 2021

Accepted: 26 August 2022

Article published online:
23 December 2022

© 2022. Thieme. All rights reserved.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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