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This research aims to examine trends in meniscal procedures during ACL reconstruction and assess reoperation rates.

April 16, 2026Open Access

Increasing meniscal repair rates during ACL reconstruction did not increase reoperation risk: An analysis of surgical trends from 2015 to 2023

Key Points

This research aims to examine trends in meniscal procedures during ACL reconstruction and assess reoperation rates.
Analyzed 2748 knees undergoing primary ACLR with concomitant meniscal procedures from 2015 to 2023.
Stratified data into two time periods: 2015–2019 and 2020–2023.
Identified meniscal reoperations and collected KOOS data preoperatively and at two years post-surgery.
Conducted subgroup analysis on reoperation rates for medial, lateral, and combined meniscal procedures.
Performed multivariable analysis to compare reoperation odds between the two periods.
Increased meniscal repairs from 18.0% to 30.2%, p < 0.001, and decreased resections from 21.1% to 15.1%, p < 0.001.
No significant difference in reoperation rates for repairs (9.0% vs. 11.4%, n.s.) or resections (5.0% vs. 3.9%, n.s.).
Combined medial and lateral procedures had higher reoperation rates (11.7%) compared to medial (6.5%) and lateral (7.8%) procedures (p < 0.001).
Lateral meniscal resections had higher reoperation rates (2.8%) compared to medial (1.4%) and combined resections (1.5%) (p = 0.04).
Lower odds of reoperation in 2020-2023 compared to 2015-2019 (OR = 0.39; 95% CI 0.26-0.60; p < 0.001).

Abstract

Abstract Purpose To evaluate surgical trends over time in meniscal procedures during anterior cruciate ligament reconstruction (ACLR) and compare meniscal reoperation rates and subjective outcomes between 2015–2019 and 2020–2023. Methods This study included 2748 knees undergoing primary ACLR with concomitant meniscal procedures at Capio Artro Clinic, Stockholm, Sweden, stratified by time period (2015–2019 vs. 2020–2023). Meniscal reoperations within two years were identified through medical records, Knee injury and Osteoarthritis Outcome Score (KOOS) was collected preoperatively and at two years for patients undergoing meniscal repair. Minimal important change (MIC), patient‐acceptable symptom state (PASS) and treatment failure (TF) were assessed through KOOS 4 . Subgroup analysis compared reoperation rates following medial, lateral and combined medial and lateral meniscal procedures. Results The proportion of meniscal repairs increased (18.0%–30.2%, p < 0.001), whereas meniscal resections decreased (21.1%–15.1%, both p < 0.001) from 2015–2019 to 2020–2023. Meniscal reoperation rates did not differ significantly between cohorts for repairs (9.0% vs. 11.4%, p = not significant (n.s.)) or resections (5.0% vs. 3.9%, p = n.s.). Combined medial and lateral meniscal procedures had significantly higher meniscal reoperation rates overall (11.7%) compared to medial (6.5%) and lateral (7.8%) meniscal procedures ( p < 0.001). Lateral meniscal resections resulted in significantly more reoperations (2.8%) compared to medial (1.4%) and combined (1.5%) meniscal resections ( p = 0.04) within the full cohort. There were no significant differences between cohorts in MIC, PASS, or TF. Multivariable analysis showed lower odds of reoperation in 2020–2023 compared to 2015–2019 (odds ratio OR = 0.39; 95% confidence interval CI 0.26–0.60; p < 0.001). Conclusion Meniscal repair rates during ACLR increased significantly over time, while short‐term reoperation rates and patient‐reported outcomes remained unchanged. These findings align with the increasing emphasis on meniscal preservation in clinical practice. Level of Evidence Level III.

Increasing meniscal repair rates during ACL reconstruction did not increase reoperation risk: An analysis of surgical trends from 2015 to 2023

Key Points

Abstract

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