Meniscal Tears in Concomitant ACL Injuries: A Review of Meniscal Repair as a Treatment Option

The anterior cruciate ligament (ACL) is a common injury in sports such as football, soccer, and wrestling, and often results in concurrent injury to the meniscus, a thin cartilaginous tissue in the knee. As such, there has been increasing emphasis on meniscal repair as the significance of its roles in load transmission, shock absorption, stability, and lubrication of the articular surface is recognized. The most common methods of preserving meniscus function include leaving stable or partial tears in situ for self-healing, partial meniscectomy, or meniscal repair. While a 2004 study suggested that stable meniscal tears could be left in situ to self-heal following ACL reconstruction (ACLR) operations, studies conducted after 2,000 point to a rising prevalence for performing meniscal repair concurrently with ACLR. These studies suggest that minimally traumatized tears, longitudinal tears, lesions occurring in the vascularized portions of the meniscus, and meniscus root tears or ramp lesions are all cases where meniscal repair is typically preferred. Advancements made in arthroscopic surgery and increasing understanding of meniscal function are making meniscal repair an appealing treatment option. However, whether meniscal repair is the most optimal treatment option for every patient is still unclear, and the studies claiming meniscal repair to be preferable all have their limitations. A 2006-2018 trend analysis study suggested that meniscal repair is becoming a more popular option, but its observation period was only 180 days, which may have failed to capture injuries that would occur early after return to sport. Therefore, further research and clinical data are needed to help determine the best course of action for ACL injuries with concomitant meniscus tears.