Risk factors for lateral meniscus posterior root tears in the anterior cruciate ligament injured knee: an epidemiological analysis of 3956 patients from the SANTI database

Praz, C., Vieira, T.D., Saithna, A. ORCID: 0000-0002-2408-5307, Rosenstiel, N., Kandhari, V., Nogueira, H. and Sonnery-Cottet, B., 2019. Risk factors for lateral meniscus posterior root tears in the anterior cruciate ligament injured knee: an epidemiological analysis of 3956 patients from the SANTI database. The American Journal of Sports Medicine, 47 (3), pp. 598-605. ISSN 0363-5465

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Abstract

Background: Lateral meniscal posterior root tears (LMPRT) result in loss of hoop forces and significant increases in tibiofemoral contact pressures. Pre-operative imaging lacks reliability and therefore holding an appropriate index of suspicion, based on the epidemiology and risk factors for LMPRT, may reduce the rate of missed diagnoses.

Hypothesis/Purpose: The primary objectives of this study were to evaluate the incidence and risk factors for lateral meniscus root lesions in a large series of patients undergoing anterior cruciate ligament (ACL) reconstruction.

Study Design: Case series.

Methods: All patients who underwent primary or revision ACL reconstruction, between January 2011 to April 2018 were considered for study eligibility. From this overall population, all patients who underwent repair of a lateral meniscus posterior root tear (LMPRT) were identified. The epidemiology of LMPRT was defined by the incidence within the study population, stratified by key demographic parameters. Potentially important risk factors for the presence of LMPRT were evaluated in multivariate logistic regression analysis.

Results: 3956 patients undergoing ACL reconstruction were included in the study. A LMPRT was identified and repaired in 262 patients (6.6%). Multivariate analyses demonstrated that significant risk factors for LMPRT included a contact sports injury mechanism (7.8% incidence with contact sports mechanism vs 4.5% with non-contact mechanism 4.5%; OR = 1.69, IC95% 1.266 - 2.285; P <.001) and the presence of a medial meniscal tear (7.9% incidence with medial meniscal tear vs 5.8% in those without; OR = 1.532, IC95% 1.185 - 1.979; P <.001). Although the incidence of LMPRT in male patients (7.3%) was higher than females (4.8%) this was not significant in multivariate analysis (P = 0.270). Patient age, revision ACL reconstruction and a pre-operative side to side laxity difference of ≥ 6mm were not found to be significant risk factors for LMPRT.

Conclusion: The incidence of LMPRT was 6.6% in a large series of patients undergoing ACL reconstruction. Participation in contact sports and the presence of a concomitant medial meniscal tear were demonstrated to be important independent risk factors. Their presence should raise the index of suspicion of this injury pattern.

Item Type: Journal article
Publication Title: The American Journal of Sports Medicine
Creators: Praz, C., Vieira, T.D., Saithna, A., Rosenstiel, N., Kandhari, V., Nogueira, H. and Sonnery-Cottet, B.
Publisher: SAGE in association with the American Orthopaedic Society for Sports Medicine
Date: 1 March 2019
Volume: 47
Number: 3
ISSN: 0363-5465
Identifiers:
NumberType
10.1177/0363546518818820DOI
Divisions: Schools > School of Science and Technology
Depositing User: Jill Tomkinson
Date Added: 27 Feb 2019 14:34
Last Modified: 16 Jan 2020 03:00
URI: http://irep.ntu.ac.uk/id/eprint/35832

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