Meniscal Repairs Performed With Posterior Cruciate Ligament Reconstruction Are Associated With Lower Failure Rates Than Isolated Repairs.

Purpose

To assess the incidence of meniscal repair (MR) failure after posterior cruciate ligament reconstruction (PCLR) + MR compared with MR alone.

Methods

Patients undergoing isolated PCLR + MR or MR alone were identified from a large insurance database (PearlDiver). A cohort of isolated ACLR + MR was also developed to provide reference data. Demographic, surgical, and comorbidity data were collected and controlled for. The primary outcome was ipsilateral repair failure defined as revision meniscal surgery at 2 years. Secondary outcomes included ipsilateral revision or conversion arthroplasty (RoA). Time-to-event analyses were used to compare outcomes between groups.

Results

There were 21,358 patients (0.9% PCLR + MR, 99.1% MR alone) with a mean follow-up of 3.1 ± 2.1 years. Compared with patients who underwent MR alone, patients who underwent PCLR + MR had significantly lower meniscal failure (unadjusted: 4.1% vs 8.4%, P = .04; adjusted hazard ratio [HR]: 0.41 [0.20-0.82], P = .01) and RoA (unadjusted: 4.1% vs 8.7%, P = .03; adjusted HR: 0.40 [0.20-0.80], P = .01) rates at 2 years. For reference, compared with MR alone, a similar improvement in failure rates was seen with concomitant ACLR + MR (unadjusted: 5.6% vs 8.4%, P < .001; adjusted HR: 0.61 [0.57-0.66], P < .001), whereas there was no difference between PCLR + MR and ACLR + MR (unadjusted: 4.1% vs 5.6%, P = .40; adjusted HR: 0.64 [0.32-1.29], P = .21).

Conclusions

MRs performed concomitantly with PCLR were associated with significantly lower failure rates compared with isolated MRs, with an effect size comparable to that of ACLR + MR. LEVEL OF EVIDENCE Level III, retrospective comparative cohort study.