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

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