Shared ACL Bone Tunnel Technique for Repair of Lateral Meniscus Posterior Root Tears Combined With ACL Reconstruction

Abstract

Background: Independent transtibial pullout repair is a common surgical technique for repairing lateral meniscus posterior root tears (LMPRTs). The shared anterior cruciate ligament (ACL) bone tunnel technique is an alternative technique for LMPRT repair combined with ACL reconstruction (ACLR) to avoid the establishment of additional bone tunnels. Purpose: To compare the clinical outcomes of the shared ACL bone tunnel versus the independent transtibial pullout techniques for LMPRT repair combined with ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: Between March 2014 and February 2018, a total of 48 patients were diagnosed with ACL injury with concomitant LMPRT; 22 patients underwent independent transtibial pullout repair (group T), and 26 patients underwent the shared ACL bone tunnel technique (group S). At a follow-up of >2 years, we compared knee functional recovery using the Lysholm, Tegner, and International Knee Documentation Committee scores and the pivot-shift test. Lateral meniscal extrusion, and cartilage degeneration on magnetic resonance imaging (MRI) scans were also compared. The healing status of the lateral meniscus posterior root was compared using second-look arthroscopy and MRI. Results: The duration of surgery was significantly shorter in group S compared with group T (98.3 ± 11.1 vs 127.9 ± 17.5 min; P =.001). At final follow-up, there were no significant differences between the 2 groups in knee functional scores, pivot shift, or grade of cartilage degeneration. Lateral meniscal extrusion was decreased in group S compared with group T (2.41 ± 0.61 vs 1.59 ± 1.35 mm; P =.014). Second-look arthroscopy revealed stable healing in 16 of 18 patients (88.9%) in group S and 10 of 15 patients (66.7%) in group T (P =.38). Conclusion: Both the shared ACL bone tunnel and the independent transtibial pullout techniques led to satisfactory clinical outcomes. The shared ACL bone tunnel technique is the simpler of the 2 procedures for combined LMPRT repair with ACLR.