Evaluation of Peripheral Vertical Nondegenerative Medial Meniscus Tears Treated With Trephination Alone at the Time of Anterior Cruciate Ligament Reconstruction.

PURPOSE

To determine (1) subjective results and incidence of symptomatic medial meniscus tears (MMTs) in patients treated with trephination alone compared with a control group without meniscus tears and (2) if trephination treatment resulted in a higher incidence of knee arthritis compared with controls with intact menisci.

METHODS

Between 1997 and 2010, 419 patients met the inclusion criteria of having an isolated anterior cruciate ligament (ACL) tear, peripheral vertical nondegenerative MMT treated with trephination alone, no lateral meniscus tears, normal radiographs before surgery, and no bilateral knee involvement. A control group of 462 patients included patients who met the same criteria but without MMT. Objective data included International Knee Documentation Committee (IKDC) objective evaluation. Subjective data included IKDC and Cincinnati Knee Rating System (CKRS) scores.

RESULTS

Objective follow-up was obtained for 191 patients in the study group and 200 patients in the control group (mean, 5.6 and 5.9 years, respectively; range, 2 to 16 years). Subjective survey follow-up was obtained for 312 patients in the study group and 343 patients in the control group (mean, 7.0 and 7.1 years, respectively). The mean CKRS score was 91.8 ± 13.3 for the study group and 92.3 ± 10.9 for the control group (P = .27). The mean IKDC score was 86.5 ± 15.8 for the study group and 86.7 ± 16.3 for the control group (P = .81). Subsequent MMTs occurred in 51 patients (16.3%) in the study group and 20 patients (5.8%) in the control group (P < .0001). IKDC radiographic ratings were normal for 95% of the study group and 92% of the control group (P = .18).

CONCLUSIONS

Patients with peripheral nondegenerative MMTs treated with trephination alone had a 16.3% rate of subsequent symptomatic MMTs compared with 6% in patients with intact menisci. However, no statistically significant differences were found between groups for radiographic and subjective results.

LEVEL OF EVIDENCE

Level III, therapeutic case control study.