Lambrey Pierre-Jean, Fayard Jean-Marie, Graveleau Nicolas, Toanen Cécile, Noailles Thibaut, Letartre Romain, Barth Johannes, Cavaignac Etienne, Bouguennec Nicolas, Thaunat Mathieu
Ramsay Santé, Hôpital privé Jean Mermoz, Centre Orthopédique Santy, FIFA Medical Center of Excellence, Lyon, France.
Clinique du Sport de Bordeaux-Mérignac, Bordeaux, France.
Arthroscopy. 2025 Apr;41(4):1030-1038. doi: 10.1016/j.arthro.2024.05.028. Epub 2024 Jun 12.
To determine the incidence of lateral meniscus posterior root tears (LMPRTs) in patients undergoing anterior cruciate ligament (ACL) reconstruction and identify associated risk factors.
We conducted a retrospective, multicenter study using data from the Francophone Arthroscopic Society's registry. The study included all the patients in the registry who underwent ACL reconstruction surgery between June 2020 and June 2023; we excluded incomplete data. We compared delay from injury to surgery between LMPRTs group and no-LMPRTs group. Variables investigated as potential risk factors for LMPRTs included age, sex, nature of surgery (primary or revision), pivot shift test result, side-to-side laxity under anesthesia, presence of ACL remnant, occurrence of medial meniscal tear, and presence of collateral ligament injury. Risk factors were analyzed using a logistic regression model.
Among the 5,359 patients analyzed, LMPRTs occurred in 7.0% (n = 375) of cases during ACL reconstruction. Mean age at surgery was 29.3 ± 10.3 years old [11-77]. Concerning delay to surgery, the mean time was 8.4 ± 23.1 weeks [0.0-347.2] in the no-LMPRTs group and 6.5 ± 10.2 weeks [0.2-61.6] in the LMPRTs group (P = .109). Univariate analysis revealed that male sex (P < .001), revision surgery (P < .001), medial meniscal injury (P = .007), ACL remnant (0% vs >70%, <10% vs >70%, 10%-30% vs >70%, >30%-50% vs >70%, >50%-70% vs >70%; P < .001), and greater pivot shift grade (P = .011) were significantly associated with a presence of LMPRTs. Age, side-to-side laxity, and collateral ligament injury were not found to be significant risk factors. In multivariate analysis, male sex, revision surgery, pivot shift test result, and a low volume of ACL remnant remained significant. Side-to-side laxity was also a significant factor in multivariate analysis.
This study identified male sex, revision surgery, low volume of ACL remnant, side-to-side laxity, and greater grade of pivot shift as significant risk factors for LMPRTs during ACL reconstruction.
Level III, retrospective comparative case series.
确定前交叉韧带（ACL）重建患者中外侧半月板后根撕裂（LMPRT）的发生率，并识别相关危险因素。
我们使用法语国家关节镜学会登记处的数据进行了一项回顾性多中心研究。该研究纳入了登记处中2020年6月至2023年6月期间接受ACL重建手术的所有患者；我们排除了不完整的数据。我们比较了LMPRT组和非LMPRT组从受伤到手术的延迟时间。作为LMPRT潜在危险因素进行调查的变量包括年龄、性别、手术性质（初次或翻修）、轴移试验结果、麻醉下的侧方松弛度、ACL残端的存在、内侧半月板撕裂的发生以及侧副韧带损伤的存在。使用逻辑回归模型分析危险因素。
在分析的5359例患者中，7.0%（n = 375）的病例在ACL重建期间发生了LMPRT。手术时的平均年龄为29.3±10.3岁[11 - 77岁]。关于手术延迟时间，非LMPRT组的平均时间为8.4±23.1周[0.0 - 347.2周]，LMPRT组为6.5±10.2周[0.2 - 61.6周]（P = 0.109）。单因素分析显示，男性（P < 0.001）、翻修手术（P < 0.001）、内侧半月板损伤（P = 0.007）、ACL残端（0%对>70%，<10%对>70%，10% - 30%对>70%，>30% - 50%对>70%，>50% - 70%对>70%；P < 0.001）以及更高的轴移分级（P = 0.011）与LMPRT的存在显著相关。年龄、侧方松弛度和侧副韧带损伤未被发现是显著的危险因素。在多因素分析中，男性、翻修手术、轴移试验结果和少量的ACL残端仍然显著。侧方松弛度在多因素分析中也是一个显著因素。
本研究确定男性、翻修手术、少量的ACL残端、侧方松弛度以及更高的轴移分级是ACL重建期间LMPRT的显著危险因素。
III级，回顾性比较病例系列。
