Comparison of partial meniscectomy versus meniscus repair for bucket-handle lateral meniscus tears in anterior cruciate ligament reconstructed knees.
OBJECTIVE
For patients who underwent anterior cruciate ligament (ACL) reconstruction and had an unstable bucket-handle tear and no other meniscus lesions or articular damage, we sought to determine if repair of the lateral meniscus was superior to partial meniscectomy with regard to subjective and objective results.


METHODS
Retrospective cohort study.


METHODS
Between 1982 and 1995, 91 patients met the inclusion criteria of having an ACL tear and an isolated unstable, bucket-handle meniscus tear. Patients were excluded if they had medial meniscus tears or chondral lesions. All patients underwent ACL reconstruction using patellar tendon autografts. Sixty-seven lateral menisci underwent repair using an inside-outside technique, while 24 lateral menisci were partially excised. Subjective follow-up evaluation was obtained with a modified Noyes questionnaire. Patients were objectively evaluated according to International Knee Documentation Committee (IKDC) knee evaluation criteria.


RESULTS
The mean subjective total score for the repair group was 92.5 +/- 9.4 (mean time, 7.0 +/- 2.6 years postoperatively), and the mean score for the removal group was 88.7 +/- 13.2 (mean time 11.1 +/- 4.0 years; P =.2014). The mean pain scores were 16.8 +/- 3.1 points for the repair group and 14.0 +/- 4.0 for the partial excision group, which was statistically significant (P =.0478). The distribution of IKDC overall grades was not statistically significantly different between groups (P =.0947). Two of 67 meniscus repairs failed, requiring subsequent removal.


CONCLUSIONS
Results showed that patients in the partial meniscectomy group had more pain than in the repair group, but no statistically significant difference was found between groups for overall subjective score or IKDC grade. Further follow-up evaluation is needed before definitive treatment can be recommended.


METHODS
Level III.
Shelbourne
K Donald
KD
Shelbourne Clinic at Methodist Hospital, Indianapolis, Indiana, USA. tgray@aclmd.com
Dersam
Michael D
MD
D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013710:Tendons / Q000637:transplantation*; D000070600:Tibial Meniscus Injuries; D016896:Treatment Outcome