title: Outcomes After Anterior Cruciate Ligament Reconstruction Using the Norwegian Knee Ligament Registry of 4691 Patients: How Does Meniscal Repair or Resection Affect Short-term Outcomes?
abstract: BACKGROUND
  While the effects of concurrent meniscal resection and anterior cruciate ligament reconstruction (ACLR) are known to decrease patient outcomes and increase the rate of osteoarthritis over the long term, overall short-term patient functional outcomes in a large cohort of patients are not well known.
  
  
  OBJECTIVE
  The purpose of this study was to compare the preoperative and 2-year postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale scores after ACLR with and without meniscal injury. The hypothesis was that, in comparison with an isolated ACLR, patients with a medial meniscal (MM) or lateral meniscal (LM) resection with an ACLR would have significantly decreased 2-year postoperative KOOS outcomes, while those with an ACLR with an MM or LM repair would be indistinguishable from isolated ACLR.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  The Norwegian Knee Ligament Registry (NKLR) was used to evaluate outcomes for a total of 4691 patients with primary ACLR. The KOOS scoring system was used to evaluate patients on 5 subscales (Pain, Other Symptoms, Activities of Daily Life [ADL], Sport and Recreation Function, and Quality of Life [QoL]) at time of surgery and at 2-year postoperative follow-up. Patients with isolated ACLR and ACLR with LM repair, LM resection, MM repair, or MM resection were compared using multiple linear regression modeling.
  
  
  RESULTS
  Preoperatively, in comparison with isolated ACLR, patients who had an ACLR with either an MM repair or MM resection had significantly lower scores for all KOOS subscores, and LM repair had significantly decreased scores on the Other Symptoms, Pain, and ADL subscales. Postoperatively, in comparison with isolated ACLR, 2-year KOOS outcomes were not significantly different between patients with ACLR and LM repair, MM resection, or LM resection; however, those with MM repair had significantly lower scores on the Other Symptoms and QoL subscales.
  
  
  CONCLUSIONS
  Patients with ACLR with meniscal resections do not exhibit decreased clinical outcomes at 2 years postoperatively. It is recommended that clinicians follow patients with ACLR and concurrent meniscal treatment for longer than 2 years postoperatively.
authors: Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway Steadman Philippon Research Institute, Vail, CO, USA.
authors: Christopher M
authors: CM
authors: LaPrade
authors: Steadman Philippon Research Institute, Vail, CO, USA.
authors: Grant J
authors: GJ
authors: Dornan
authors: Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway Norwegian Knee Ligament Registry, Bergen, Norway Oslo University Hospital, University of Oslo, Oslo, Norway Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway.
authors: Lars-Petter
authors: LP
authors: Granan
authors: Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway The Steadman Clinic, Vail, CO, USA.
authors: Robert F
authors: RF
authors: LaPrade
authors: Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway Norwegian Knee Ligament Registry, Bergen, Norway Oslo University Hospital, University of Oslo, Oslo, Norway lars.engebretsen@medisin.uio.no.
authors: Lars
authors: L
authors: Engebretsen
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D016014:Linear Models; D008297:Male; D020370:Osteoarthritis, Knee / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D011788:Quality of Life; D012042:Registries; D000070600:Tibial Meniscus Injuries; D055815:Young Adult
keywords: anterior cruciate ligament; meniscal repair; meniscal resection; patient outcomes; registry