Meniscal procedures are not increased with delayed ACL reconstruction and rehabilitation: results from a randomised controlled trial

Review written by Dr Christina Le info

Key Points

  1. Following an ACL rupture there is no difference in the number of meniscus surgeries performed in individuals who undergo early ACL reconstruction compared to those who pursue rehabilitation with optional delayed ACL reconstruction.
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BACKGROUND & OBJECTIVE

Experiencing a meniscus injury can change the trajectory of one’s knee health. In the short-term, meniscus injuries lead to short-term symptoms such as pain, swelling, and locking. In the long-term, they are associated with a high risk of developing osteoarthritis. Unfortunately, concomitant meniscus tears occur in 40-60% of anterior cruciate ligament (ACL) ruptures (1). It is commonly thought that undergoing ACL reconstruction minimizes further injury to the meniscus, however, the current evidence is inconclusive.

The objective of this study was to compare the number of meniscus surgeries in individuals with an ACL rupture who had early ACL reconstruction or initial non-operative treatment with optional delayed ACL reconstruction over two years.

Concomitant meniscus tears occur in 40-60% of anterior cruciate ligament ruptures.
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How to best protect the meniscus and optimize long-term health should be top considerations following an ACL rupture.

METHODS

This was a secondary analysis of the Conservative vs Operative Methods for Patients with ACL Rupture Evaluation (COMPARE) trial, a randomized controlled trial comparing early ACL reconstruction vs. rehabilitation with optional delayed ACL reconstruction treatment strategies (2). Individuals with an

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