What is your thoughts on meniscus repair prior to ACLR?
In patients with ACL injuries and concomitant meniscal tears, does performing meniscal repair prior to ACL reconstruction, compared to concurrent meniscal repair and ACL reconstruction, result in a better success rate?
I have noticed that many patients with meniscal and ACL injuries are offered meniscus surgery first, followed by ACL reconstruction at a later stage. I have always wondered why this is the case as I fear massive muscle atrophy especially if there was a brace and Non weight bearing regime. I understand the rationale if the goal is to avoid ACL reconstruction. However, if the decision has already been made to perform both the meniscal repair and ACL reconstruction, why not do them in the same surgery?
One study compared the outcomes of meniscal repair done before ACL reconstruction (group 1) versus concurrent meniscal repair and ACL reconstruction (group 2). The success rate for group 1 was only 50% (12/24), whereas it was 72% (106/148) for meniscal repair performed during ACL reconstruction. The mean time between meniscal repair and ACL reconstruction in group 1 was 2.8 months (range: 0.9–12.1 months).
What are your thoughts on splitting meniscal repair and ACL reconstruction into two separate surgeries? How much time would you recommend between the procedures?
