Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: 6-Year Follow-up Results From the MARS Cohort.
| Title: | Meniscal Repair in the Setting of Revision Anterior Cruciate Ligament Reconstruction: 6-Year Follow-up Results From the MARS Cohort. |
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| Authors: | Fox JA; Vanderbilt University, Nashville, Tennessee, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Huston LJ; Vanderbilt University, Nashville, Tennessee, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Haas AK; Washington University in St. Louis, St. Louis, Missouri, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Pennings JS; Vanderbilt University, Nashville, Tennessee, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Allen CR; Yale University, New Haven, Connecticut, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Cooper DE; W.B. Carrell Memorial Clinic, Dallas, Texas, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; DeBerardino TM; UT Health, San Antonio, Texas, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Dunn WR; Fondren Orthopedic Group, Houston, Texas, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Lantz BBA; Slocum Research and Education Foundation, Eugene, Oregon, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Spindler KP; Cleveland Clinic, Cleveland, Ohio, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Stuart MJ; Mayo Clinic, Rochester, Minnesota, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Amendola AN; Duke University, Durham, North Carolina, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Annunziata CC; Commonwealth Orthopaedics & Rehabilitation, Arlington, Virginia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Arciero RA; University of Connecticut Health Center, Farmington, Connecticut, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Bach BR Jr; Rush University Medical Center, Chicago, Illinois, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Baker CL 3rd; The Hughston Clinic, Columbus, Georgia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Bartolozzi AR; 3B Orthopaedics, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Baumgarten KM; Orthopedic Institute, Sioux Falls, South Dakota, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Berg JH; Town Center Orthopaedic Associates, Reston, Virginia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Bernas GA; State University of New York at Buffalo, Buffalo, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Brockmeier SF; University of Virginia, Charlottesville, Virginia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Brophy RH; Washington University in St. Louis, St. Louis, Missouri, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Bush-Joseph CA; Rush University Medical Center, Chicago, Illinois, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Brad Butler V J; Orthopedic and Fracture Clinic, Portland, Oregon, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Carey JL; University of Pennsylvania, Philadelphia, Pennsylvania, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Carpenter JE; University of Michigan, Ann Arbor, Michigan, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Cole BJ; Rush University Medical Center, Chicago, Illinois, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Cooper JM; HealthPartners Specialty Center, St. Paul, Minnesota, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Cox CL; Vanderbilt University, Nashville, Tennessee, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Creighton RA; University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; David TS; Synergy Specialists Medical Group, San Diego, California, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Flanigan DC; The Ohio State University, Columbus, Ohio, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Frederick RW; The Rothman Institute/Thomas Jefferson University, Philadelphia, Pennsylvania, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Ganley TJ; Children's Hospital of Philadelphia, Philadelphia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Gatt CJ Jr; University Orthopaedic Associates, Princeton, New Jersey, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Gecha SR; Princeton Orthopaedic Associates, Princeton, New Jersey, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Giffin JR; Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Hame SL; University of California, Los Angeles, California, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Hannafin JA; Hospital for Special Surgery, New York, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Harner CD; University of Texas Health Center, Houston, Texas, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Harris NL Jr; Grand River Health, Rifle, Colorado, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Hechtman KS; Miami Orthopedics and Sports Medicine Institute, Coral Gables, Florida, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Hershman EB; Lenox Hill Hospital, New York, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Hoellrich RG; Slocum Research and Education Foundation, Eugene, Oregon, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Johnson DC; National Sports Medicine Institute, Leesburg, Virginia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Johnson TS; National Sports Medicine Institute, Leesburg, Virginia, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Jones MH; Brigham and Women's Hospital, Boston, Massachusetts, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Kaeding CC; The Ohio State University, Columbus, Ohio, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Kamath GV; University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Klootwyk TE; Forte Sports Medicine and Orthopedics, Indianapolis, Indiana, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Levy BA; Orlando Health, Orlando, Florida, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Ma CB; University of California, San Francisco, California, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Maiers GP 2nd; Forte Sports Medicine and Orthopedics, Indianapolis, Indiana, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Marx RG; Hospital for Special Surgery, New York, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Matava MJ; Washington University in St. Louis, St. Louis, Missouri, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Mathien GM; Knoxville Orthopedic Clinic, Knoxville, Tennessee, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; McAllister DR; University of California, Los Angeles, California, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; McCarty EC; University of Colorado Denver School of Medicine, Denver, Colorado, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; McCormack RG; University of British Columbia/Fraser Health Authority, New Westminster, British Columbia, Canada.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Miller BS; University of Michigan, Ann Arbor, Michigan, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Nissen CW; Connecticut Children's Medical Center, Hartford, Connecticut, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; O'Neill DF; The Alpine Clinic, Plymouth, New Hampshire, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Owens BD; Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Parker RD; Cleveland Clinic, Cleveland, Ohio, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Purnell ML; Valley Ortho, Aspen, Colorado, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Ramappa AJ; Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Rauh MA; State University of New York at Buffalo, Buffalo, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Rettig AC; Forte Sports Medicine and Orthopedics, Indianapolis, Indiana, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Sekiya JK; University of Michigan, Ann Arbor, Michigan, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Shea KG; Stanford University, Palo Alto, California, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Sherman OH; NYU Hospital for Joint Diseases, New York, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Slauterbeck JR; UNC Health Southeastern, Lumberton, North Carolina, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Smith MV; Washington University in St. Louis, St. Louis, Missouri, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Spang JT; University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Svoboda CRSJ; MedStar Orthopaedic and Sports Center, Washington, DC, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Taft TN; University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Tenuta JJ; Albany Medical Center, Albany, New York, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Tingstad EM; Inland Orthopaedic Surgery and Sports Medicine Clinic, Pullman, Washington, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Vidal AF; The Steadman Clinic, Vail, Colorado, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Viskontas DG; Fraser Orthopaedic Institute, New Westminster, British Columbia, Canada.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; White RA; Fitzgibbon's Hospital, Marshall, Missouri, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Williams JS Jr; Cleveland Clinic, Euclid, Ohio, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Wolcott ML; University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Wolf BR; University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; York JJ; Luminis Health Orthopedics, Pasadena, Maryland, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Wright RW; Vanderbilt University, Nashville, Tennessee, USA.; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA. |
| Corporate Authors: | MARS Group;; Investigation performed at Vanderbilt University Medical Center, Nashville, Tennessee, USA. |
| Source: | The American journal of sports medicine [Am J Sports Med] 2025 Dec; Vol. 53 (14), pp. 3435-3445. Date of Electronic Publication: 2025 Nov 11. |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2004- : Thousand Oaks, CA : Sage Publications; Original Publication: Baltimore, Williams & Wilkins. |
| MeSH Terms: | Anterior Cruciate Ligament Reconstruction*/methods ; Anterior Cruciate Ligament Injuries*/surgery ; Menisci, Tibial*/surgery ; Tibial Meniscus Injuries*/surgery; Humans ; Reoperation ; Male ; Female ; Follow-Up Studies ; Adult ; Prospective Studies ; Young Adult ; Adolescent ; Middle Aged |
| Abstract: | Background: Meniscal preservation has been demonstrated to contribute to long-term knee health and has been a successful intervention in isolation and in patients with anterior cruciate ligament reconstruction (ACLR). The long-term results of meniscal repair in the setting of revision ACLR have yet to be documented.; Purpose: To report the incidence of meniscal repair failures at the 6-year follow-up in a cohort of patients who underwent concurrent revision ACLR and primary meniscal repair.; Study Design: Prospective cohort study; Level of evidence, 2.; Methods: All revision ACLRs with concomitant primary meniscal repair cases from a multicenter group between 2006 and 2011 were selected. Six-year follow-up was obtained to determine whether any subsequent surgery had occurred since their initial revision ACLR. If so, operative reports were obtained, whenever possible, to verify pathological condition and treatment.; Results: In total, 221 patients from 1234 revision ACLRs underwent concurrent primary meniscal repairs (18% of the cohort). There were 238 repairs performed: 173 medial and 65 lateral. The majority of these repairs (n = 181; 76%) were performed with an all-inside technique. Six-year surgical follow-up was obtained in 77% (171/221) of the cohort, or 189 of 238 (79%) of the repairs (136 medial, 53 lateral). The meniscal repair failure rate, defined as reoperation, was 16% (31/189) at 6 years. Of the 31 failures, 28 were medial (24 all-inside, 4 inside-out; 28/136 = 20.6% failure rate) and 3 were lateral (2 all-inside, 1 inside-out; 3/53 = 5.7% failure rate). Three medial failures were treated in conjunction with a subsequent repeat revision ACLR. Medial tears underwent reoperation for failure at a significantly higher rate than lateral tears (20.6% vs 5.7%; P = .01) and had a significantly shorter survival time compared with lateral tears (P = .02). No difference was found between the failure and nonfailure groups when it came to tear type, tear length, repair technique utilized, suture/implant type, or number of sutures used between the 2 groups.; Conclusion: Meniscal repair in the revision ACLR setting has a 16% failure rate at 6 years. Failure rates for medial tears (20.6%) were found to be higher than that for lateral tears (5.7%), which aligns with previous studies in both the revision and primary ACLR setting. |
| Competing Interests: | One or more of the authors has declared the following potential conflict of interest or source of funding: This project was funded by grant No. 5R01 AR060846 from the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases. D.E.C. has received royalties or license from DJO and Stryker; and consulting fees from DJO. T.M.D. has received royalties, consulting fees, and speaking fees from Arthrex; and consulting fees from Kowa Pharmaceuticals American. K.P.S. has received support for education from Summit Surgical and consulting fees from NovoPedics. M.J.S. has received royalties, consulting fees, and speaking fees from Arthrex; and grant and support for education from Smith & Nephew. A.A. has received royalties and consulting fees from Arthrex; consulting fees from LimaCorporate and DJO; travel support from Lima USA; support for education from Southtech Orthopedics and Tricoast Surgical Solutions; and acquisitions and investment interest in Anika Therapeutics. C.C.A. has received support for education from Arthrex and Supreme Orthopedics Systems. R.A.A. has received acquisitions and consulting fees from Linvatec Coporation; and consulting fees from Biorez and Smith & Nephew. B.R.B. has received consulting fees from OsteoCentric Technologies. C.L.B. has received travel support from Arthrex and CGG Medical. K.M.B. has received consulting fees from Miach Orthopaedics, Stryker, and Wright Medical Technology. J.H.B. has received support for education from Supreme Orthopedic Systems. G.A.B. has received support for education from Prodigy Surgical Distribution. S.F.B. has received consulting fees and royalties from Arthrex and Exactech; and royalties from Zimmer Biomet Holdings. C.A.B.J. has received a grant from DJO. J.B.B. has received consulting fees from DePuy and Medical Device Business Services; and support for education from Steelhead Surgical. J.L.C. has received consulting fees and honoraria from Vericel; speaking fees from Arthrex; and consulting fees from Bioventus and Joint Restoration Foundation; he is an associate editor for AJSM. B.J.C. has received consulting fees from Acumed, Aesculap Biologics, Anika Therapeutics, Arthrex, Averitas Pharma, Bioventus, DJO, Endo Pharmaceuticals, Ossio, Pacira Pharmaceuticals, and Vericel; royalties from Arthrex and DJO; speaking fees from Terumo BCT and Vericel; and support for education from Endo Pharmaceuticals. R.A.C. has received consulting fees from Arthrex; hospitality payment from Shoulder Innovations; and support for education from Southtech Orthopedics. T.S.D. has received consulting fees and royalties from Arthrex; and support for education from ImpactOrtho. D.C.F. has received consulting fees from Anika Therapeutics, Bioventus, DePuy Synthes Products, Linvatec, Medical Device Business Services, MOXIMED, OSSIO, Smith & Nephew, and Vericel; hospitality payments from Arcuro Medical, ERMI, and International Life Sciences; and speaking fees from Karl Storz Endoscopy–America. R.W.F. has received support for education from Liberty Surgical and hospitality payments from Stryker. C.J.G. has received hospitality payments from Smith & Nephew; and support for education from SeaPearl. S.L.H. has received consulting fees from Smith & Nephew and speaking fees from Arthrex. N.L.H. has received hospitality payments from Arthrex. K.S.H. has received acquisitions from Anika Therapeutics; and support for education from Arthrex, Southern Edge Orthopaedics, and Zimmer Biomet Holdings. R.G.H. has received support for education from Steelhead Surgical. T.S.J. has received support for education from Supreme Orthopedic Systems and hospitality payments from Arthrex. C.C.K. has received speaking fees and consulting fees from Arthrex; consulting fees from Bioventus; and speaking fees from Smith & Nephew. G.V.K. has received hospitality payments from Smith & Nephew, Stryker, and TriCoast Surgical Solutions. B.A.L. has received consulting fees and royalties from Arthrex; hospitality payments from Reel Surgical; and speaking fees from Smith & Nephew. M.J.M. has received consulting fees, speaking fees, and travel support from Arthrex; and support for education from Elite Orthopedics. D.R.M. has received honoraria from Musculoskeletal Transplant Foundation; and consulting fees and royalties from Zimmer Biomet Holdings. E.C.M. has received consulting fees from Zimmer Biomet Holdings, Bioventus, DePuy Synthes Products, Pacira Therapeutics, Medical Device Business Services, and Vericel; royalties from Zimmer Biomet Holdings; and travel support from Synthes GmbH. B.S.M. has received consulting fees from Arthrex; travel support from Exactech; consulting fees and royalties from FH Orthopedics; and support for education from Pinnacle. B.D.O. has received royalties from Linvatec; consulting fees from Linvatec, Medical Device Business Services, Vericel, and DePuy Synthes Products; and is editor in chief of AJSM. M.L.P. has received support for education from Gemini Mountain Medical. A.J.R. has received support for education from Arthrex. M.A.R. has received travel support from Smith & Nephew; support for education from Prodigy Surgical Distribution; and royalties from Stryker. K.G.S. has received consulting fees from OrthoPediatrics and nView Medical; support for education from Evolution Surgical and Elite Orthopedics; and speaking fees from Arthrex. M.V.S. has received support for education from Arthrex and Elite Orthopedics; and travel support from Medical Device Business Services. S.J.S. has received travel support and support for education from Supreme Orthopedic Systems. J.J.T. has received travel support and support for education from Arthrex and Prodigy Surgical Distribution. E.J.T. has received travel support from DePuy Synthes Sales; and support for education from Summit Surgical. R.A.W. has ownership interest in Spinal Simplicity. J.S.W. has ownership interest in Lazurite. B.R.W. has received royalties and consulting fees from Linvatec. J.J.Y. has received support for education from Supreme Orthopedic Systems. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. |
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| Grant Information: | R01 AR060846 United States AR NIAMS NIH HHS |
| Contributed Indexing: | Keywords: anterior cruciate ligament reconstruction; meniscal repair; outcomes; revision |
| Entry Date(s): | Date Created: 20251112 Date Completed: 20251201 Latest Revision: 20260403 |
| Update Code: | 20260515 |
| PubMed Central ID: | PMC12657664 |
| DOI: | 10.1177/03635465251387333 |
| PMID: | 41220248 |
| Database: | MEDLINE |
Journal Article; Multicenter Study