title: Conservative treatment of meniscal tears in anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Management of small and stable meniscal tears within the vascular zone at the time of anterior cruciate ligament (ACL) reconstruction is controversial. The purpose of this study was to evaluate the outcome of meniscal tear left in situ at the time of ACL reconstruction.
  
  
  METHODS
  Using the IKDC, KT-1000 and the Tegner Activity Score (TAS), we retrospectively analysed 175 cases of ACL reconstruction with meniscal tears performed from 2006 to 2012. Patients with residual laxity on clinical assessment were identified and considered as a subgroup. Clinical outcome and failure rate were evaluated.
  
  
  RESULTS
  In 83 patients (47.4%), a meniscal tear was left in situ at the time of ACL reconstruction: 45 were medial and 38 were lateral. Patients were clinically reassessed with a minimum follow-up of 24 months. The overall failure rate of conservative meniscal treatment in patients with objective residual laxity was 87.5%, and 6.7% in patients with a stable knee (P<0.001). Those with stable knees had higher postoperative IKDC subjective scores (P=0.0022) and TAS (P<0.0001). Patients without residual laxity had higher failure rate for the medial meniscus compared with lateral meniscus - 10.5% versus 2.7% (P=0.36)-and the red-red zone had lower revision rate compared with the red-white zone (P=0.0322).
  
  
  CONCLUSIONS
  The conservative treatment of small and stable peripheral tears of the medial and lateral menisci had low failure rate and no described complications. In our series residual laxity significantly increased the failure rate.
  
  
  METHODS
  level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genoa, Padiglione 40, IRCCS AOU San Martino - IST, Largo Rosanna Benzi 10, 16132 Genoa, Italy. Electronic address: mattia.alessio@hotmail.com.
authors.forename: Mattia
authors.initials: M
authors.lastname: Alessio-Mazzola
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genoa, Padiglione 40, IRCCS AOU San Martino - IST, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Formica
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genoa, Padiglione 40, IRCCS AOU San Martino - IST, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Coviello
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genoa, Padiglione 40, IRCCS AOU San Martino - IST, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Basso
authors.affiliation: Department of Orthopaedics and Traumatology, University of Genoa, Padiglione 40, IRCCS AOU San Martino - IST, Largo Rosanna Benzi 10, 16132 Genoa, Italy.
authors.forename: Lamberto
authors.initials: L
authors.lastname: Felli
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery / Q000628:therapy*; D007718:Knee Injuries / Q000601:surgery / Q000628:therapy*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D012189:Retrospective Studies; D000070600:Tibial Meniscus Injuries / Q000601:surgery / Q000628:therapy*; D055815:Young Adult
keywords: ACL reconstruction; Knee; Meniscal tears