A prospective clinical evaluation of meniscal repair, with or without concomitant anterior cruciate ligament reconstruction, in paediatric patients

Introduction: Studies reporting paediatric meniscal repair outcomes are limited, often retrospective and lacking objective outcomes. This study sought to determine clinical outcomes, return to sport (RTS), meniscal healing and re-injury rates in paediatric patients undergoing meniscal repair, with or without anterior cruciate ligament reconstruction (ACLR). Materials and Methods: Overall, 32 paediatric patients (mean age 13.8 years) undergoing meniscal repair were recruited, in isolation (n=14) or with ACLR (n=18). Outcomes to 24 months included patient-reported outcome measures (PROMs), RTS, isokinetic strength and a 5-hop battery. Limb Symmetry Indices (LSIs) were calculated. Re-injuries and re-operations were presented. Magnetic resonance imaging (MRI) was undertaken to assess healing. Results: All PROMs, quadriceps strength and hop test LSIs improved (p<0.05). While those undergoing isolated meniscal repair (versus those with ACLR) demonstrated higher LSIs for the triple (p=0.023) and triple crossover (p=0.019) hop tests at 6 months, and the medial hop test at 6 (p=0.042) and 12 (p=0.019) months, no other differences existed. Mean LSIs for all strength and hop tests were ≥90% at 12 and 24 months. Of the 96.4% of patients participating in Noyes Level 1 or 2 pivoting sports pre-injury, 89.3% were by 24 months. One isolated repair patient encountered a re-injury at 18 months, while one combined ACLR and meniscal repair patient suffered an ACL re-tear at 14 months. Complete or near-full healing was observed on MRI in in 68% of repairs. Conclusions: Subjective and physical performance scores improved following meniscal repair, either in isolation or concomitantly with ACLR, with high levels of RTS.