title: Factors associated with meniscus repair in patients undergoing anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Meniscus injuries are common in patients with anterior cruciate ligament (ACL) tears. Patient demographics, surgeon characteristics, and concurrent diagnostic factors affecting the prevalence of meniscus repairs in patients undergoing ACL reconstruction (ACLR) by community-based orthopaedic surgeons have not been fully studied.
  
  
  OBJECTIVE
  Patient (age, sex, race, and body mass index [BMI]), surgeon (sports medicine fellowship training status and case volume), and injury characteristics (1 or both menisci injured, injury location, and concurrent cartilage injury) and surgical venue (case volume) are associated with a higher likelihood of meniscus repair.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  A cross-sectional study using data from a large community-based ACLR registry was performed. Patients with a meniscus injury and primary ACLR between February 2005 and June 2010 were included in the study. Meniscus repair rates by patient, surgeon, and injury characteristics were described. Associations were evaluated using generalized linear models.
  
  
  RESULTS
  During the study period, 5712 primary ACLRs with a meniscus tear diagnosis were registered. There was 1 torn meniscus in 4248 (74.4%) patients, and both menisci were torn in 1464 (25.6%) patients. Medial meniscus tears were repaired in 1192 (31.2%) of 3818 cases; the remaining 2626 (68.8%) tears were not repaired, underwent alternative treatment (meniscectomy, trephination, rasped), or were left in situ. Lateral meniscus tears were repaired in 893 (26.6%) of 3358 cases; the remaining 2465 (73.4%) tears underwent alternative treatment or were left in situ. Adjusted models showed that younger patient age (P < .001), lower patient BMI (P < .001), surgeon's sports medicine fellowship training (P < .001), higher surgeon case volume (P < .001), higher surgical venue volume (P = .019), and medial meniscus tears (P < .001) were all associated with a higher likelihood of a meniscus repair.
  
  
  CONCLUSIONS
  Younger patient age, lower patient BMI, surgeon's sports medicine fellowship training, higher surgeon case volume, and higher site volume are associated with a higher likelihood of a meniscus repair in patients undergoing primary ACLR in a large cohort from a community-based ACLR registry.
authors.affiliation: Ronald W.B. Wyatt, Orthopedics Department, Kaiser-Permanente, 1425 South Main Street, Walnut Creek, CA 94596. ronald.wyatt@kp.org.
authors.forename: Ronald W B
authors.initials: RW
authors.lastname: Wyatt
authors.forename: Maria C S
authors.initials: MC
authors.lastname: Inacio
authors.forename: Kate D
authors.initials: KD
authors.lastname: Liddle
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Maletis
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D015992:Body Mass Index; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D050724:Fractures, Cartilage / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D012421:Rupture / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D000070600:Tibial Meniscus Injuries; D014945:Wound Healing; D055815:Young Adult
keywords: ACL; knee; meniscus; meniscus repair; sports medicine fellowship training