Meniscus tears in the setting of anterior cruciate ligament injury

Purpose: Meniscus tears in the setting of anterior cruciate ligament (ACL) injury can affect post-operative outcomes and stability when not treated correctly. To reduce post-operative osteoarthritis and to improve outcomes, accurate diagnosis and treatment options must be selected. The purpose of th...

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Main Authors: Koji Nukuto, Efstathios Konstantinou, Anja Maximiliane Wackerle, Jaren C. Lagreca, Camila Grandberg, Yunseo Linda Park, Brooke Collins, Volker Musahl
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Joint Surgery and Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949705124000288
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author Koji Nukuto
Efstathios Konstantinou
Anja Maximiliane Wackerle
Jaren C. Lagreca
Camila Grandberg
Yunseo Linda Park
Brooke Collins
Volker Musahl
author_facet Koji Nukuto
Efstathios Konstantinou
Anja Maximiliane Wackerle
Jaren C. Lagreca
Camila Grandberg
Yunseo Linda Park
Brooke Collins
Volker Musahl
author_sort Koji Nukuto
collection DOAJ
description Purpose: Meniscus tears in the setting of anterior cruciate ligament (ACL) injury can affect post-operative outcomes and stability when not treated correctly. To reduce post-operative osteoarthritis and to improve outcomes, accurate diagnosis and treatment options must be selected. The purpose of this review was to review recent evidence regarding biomechanics and diagnosis of meniscus injury as well as treatment options for meniscus tears, which are often complicated by ACL injuries. Methods: Studies and topics on concomitant meniscus tears in the presence of ACL injury were searched. Results: Various risk factors have been identified for meniscus tears associated with ACL injuries. As some meniscus tears are difficult to identify on magnetic resonance imaging (MRI), arthroscopic diagnosis of meniscal pathology plays a crucial role. Indications for meniscectomy should be limited due to subsequent exacerbation of post-operative instability and contribution to osteoarthritic changes. Although meniscal repair is the standard treatment for bucket handle tears, ramp lesions, lateral meniscus posterior root tears, and lateral meniscus oblique radial tears, non-operative treatment may be also effective to a certain extent for stable meniscal tears. However, the indication for non-operative treatment should be carefully considered owing to potential enlargement of the torn area. Conclusions: Inadequate treatment of concomitant meniscus tears can result in residual instability and poor outcomes despite successful ACL reconstruction. High-quality evidence on the long-term outcomes of meniscus tears complicating ACL injuries is scarce and hence future studies are required.
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spelling doaj-art-e75591feaab1439eaa8ddfd176578a802025-08-20T02:23:45ZengElsevierJournal of Joint Surgery and Research2949-70512024-12-012418018810.1016/j.jjoisr.2024.10.003Meniscus tears in the setting of anterior cruciate ligament injuryKoji Nukuto0Efstathios Konstantinou1Anja Maximiliane Wackerle2Jaren C. Lagreca3Camila Grandberg4Yunseo Linda Park5Brooke Collins6Volker Musahl7UPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USA; Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan; Corresponding author. UPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USA.UPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USAUPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USA; Department of Sports Orthopaedics, Technical University of Munich, Munich, GermanyUPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USAUPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USAUPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USAUPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USAUPMC Freddie Fu Sports Medicine Center, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, 3200 S. Water Street, Pittsburgh, PA 15203, USAPurpose: Meniscus tears in the setting of anterior cruciate ligament (ACL) injury can affect post-operative outcomes and stability when not treated correctly. To reduce post-operative osteoarthritis and to improve outcomes, accurate diagnosis and treatment options must be selected. The purpose of this review was to review recent evidence regarding biomechanics and diagnosis of meniscus injury as well as treatment options for meniscus tears, which are often complicated by ACL injuries. Methods: Studies and topics on concomitant meniscus tears in the presence of ACL injury were searched. Results: Various risk factors have been identified for meniscus tears associated with ACL injuries. As some meniscus tears are difficult to identify on magnetic resonance imaging (MRI), arthroscopic diagnosis of meniscal pathology plays a crucial role. Indications for meniscectomy should be limited due to subsequent exacerbation of post-operative instability and contribution to osteoarthritic changes. Although meniscal repair is the standard treatment for bucket handle tears, ramp lesions, lateral meniscus posterior root tears, and lateral meniscus oblique radial tears, non-operative treatment may be also effective to a certain extent for stable meniscal tears. However, the indication for non-operative treatment should be carefully considered owing to potential enlargement of the torn area. Conclusions: Inadequate treatment of concomitant meniscus tears can result in residual instability and poor outcomes despite successful ACL reconstruction. High-quality evidence on the long-term outcomes of meniscus tears complicating ACL injuries is scarce and hence future studies are required.http://www.sciencedirect.com/science/article/pii/S2949705124000288Meniscus tearAnterior cruciate ligament injuryMeniscal repairRamp lesionLateral meniscus posterior root tearLateral meniscus oblique radial tear
spellingShingle Koji Nukuto
Efstathios Konstantinou
Anja Maximiliane Wackerle
Jaren C. Lagreca
Camila Grandberg
Yunseo Linda Park
Brooke Collins
Volker Musahl
Meniscus tears in the setting of anterior cruciate ligament injury
Journal of Joint Surgery and Research
Meniscus tear
Anterior cruciate ligament injury
Meniscal repair
Ramp lesion
Lateral meniscus posterior root tear
Lateral meniscus oblique radial tear
title Meniscus tears in the setting of anterior cruciate ligament injury
title_full Meniscus tears in the setting of anterior cruciate ligament injury
title_fullStr Meniscus tears in the setting of anterior cruciate ligament injury
title_full_unstemmed Meniscus tears in the setting of anterior cruciate ligament injury
title_short Meniscus tears in the setting of anterior cruciate ligament injury
title_sort meniscus tears in the setting of anterior cruciate ligament injury
topic Meniscus tear
Anterior cruciate ligament injury
Meniscal repair
Ramp lesion
Lateral meniscus posterior root tear
Lateral meniscus oblique radial tear
url http://www.sciencedirect.com/science/article/pii/S2949705124000288
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