Think Twice Before Fixing Lateral Meniscal Tears at Time of ACL Reconstruction

A large, registry study shows no advantage to lateral meniscal repair compared to leaving it alone when you do the ACL; experience suggests some of these may heal

What’s the Claim?

A large, registry study — by far the largest on the topic — evaluating the impact of lateral meniscal tears treated or left alone at the time of primary ACL reconstruction in adults found no clinically important differences among the following groups of patients in terms of Knee Injury and Osteoarthritis Outcome Scores (KOOS) at 2, 5, and 10 years:

  • ACL reconstruction alone
  • ACL reconstruction + lateral meniscal (LM) repair
  • ACL reconstruction + LM resection
  • ACL reconstruction + no treatment of the LM tear

There were statistical differences on a few of the comparisons — on the order of two points out of 100 on the KOOS score — but nothing that a patient likely would notice. The minimum clinically important difference on the 100-point KOOS score is about 15 points, and, on average, all groups exceeded the patient acceptable symptom state on the KOOS of 57 points, meaning patients' average scores in all groups were at least acceptable to them.

How’s It Stack Up?