Trends in the surgical treatment of meniscal tears in patients with and without concurrent anterior cruciate ligament tears.

Purpose : Meniscal and anterior cruciate ligament (ACL) tears are common injuries. The purpose of this study was to determine trends in meniscal repair and meniscectomy both in the presence and absence of ACL reconstruction (ACLR). Methods : The PearlDiver database (www.pearldiverinc.com, Fort Wayne, IN) was queried for surgical management of patients who underwent arthroscopic meniscectomy (Current Procedural Terminology [CPT] codes 29880, 29881), meniscus repair (29882, 29883), and ACLR (29888) from 2010-2015. Patient groups included meniscectomy alone, meniscus repair alone, meniscus repair followed by meniscectomy, ACLR with meniscus repair, and ACLR with meniscus repair followed by meniscectomy. Linear regression was performed to determine the significance of yearly trend across each procedure. Statistical analysis was performed with RStudio, Version 1.1.442 (RStudio Inc. Boston, MA) for α value of .05. Results : The incidence of isolated meniscectomies decreased from 32.5/10,000 to 28.3/10,000 across the study period (p=0.0230), whereas the incidence of isolated meniscus repairs and all meniscus repairs remained unchanged (p=0.3000, p=0.1260). For patients undergoing concomitant meniscal repair and ACLR, the highest proportion of patients was in the age range 15-24 years old with 45.7% of patients being 15-19. Of the ACLR, 18.6% involved a concomitant meniscus repair, and 54.0% involved a concomitant meniscectomy. The risk of subsequent meniscectomy was less in patients undergoing meniscal repair with ACLR than in patients undergoing isolated meniscal repair (10.8% versus 12.4%; aOR=0.71, 95% CI 0.53-0.95, p=0.0226). Conclusions : The highest rates of concurrent meniscal repair with ACLR are in the 15-24 year-old population. From 2010-2015, the rate of meniscectomy declined while that of isolated meniscal repairs, as well as meniscal repair with ACLR remained stable. Patients undergoing meniscal repair with ACLR had lower rates of subsequent meniscectomy compared to patients undergoing isolated meniscal repair in the absence of ACL tear.