Clinical and radiographic outcomes of meniscus surgery and future targets for biologic intervention: A review of data from the MOON Group

ABSTRACT

Meniscus injury and treatment occurred with the majority of anterior cruciate ligament reconstructions (ACLR) in the multicenter orthopedic outcomes (MOON) cohort. We describe the patient-reported outcomes, radiographic outcomes, and predictors of pain from meniscus injuries and treatment in the setting of ACLR. Patient-reported outcomes improve significantly following meniscus repair with ACLR, but differences exist based on the meniscus injury laterally (medial or lateral). Patients undergoing medial meniscus repair have worse patient-reported outcomes and more pain compared to those with uninjured menisci. However, lateral meniscal tears can be repaired with similar outcomes as uninjured menisci. Medial meniscal treatment (meniscectomy or repair) results in a significant loss of joint space at 2 years compared to uninjured menisci. Menisci treated with excision had a greater degree of joint space loss compared to those treated with repair. Clinically significant knee pain is more common following injuries to the medial meniscus and increased in patients who undergo early re-operation after initial ACLR. Future research efforts aimed at improving outcomes after combined ACLR and meniscus treatment should focus on optimizing biologic and mechanical environments that promote healing of medial meniscal tears sustained during ACL injury.

KEYWORDS:

• ACL
• joint space
• meniscectomy
• meniscus
• pain
• patient-reported outcome
• repair

Acknowledgments

The authors acknowledge the efforts of the Multicenter Orthopedic Outcomes Network Group (MOON Group) physicians and support staff and Elizabeth Sosic, project manager for editorial management.

Declaration of interest

Dr. Spindler reports grants from NIH/NIAMS, Smith & Nephew Endoscopy, and DonJoy Orthopaedics, and consulting for NFL, Cytori, and Mitek.

Funding

Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Funding

Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.