Purpose
To evaluate recent trends in the treatment of meniscal tears with arthroscopic repair
and debridement and to assess revision surgery within 2 years using a large cross-sectional
database.
Methods
Patients with a diagnosis of meniscal tear from 2010 to 2017 were queried using the
Mariner data set from PearlDiver. Patient demographic data were analyzed and tracked
via International Classification of Diseases, Tenth Revision codes to investigate subsequent ipsilateral meniscal procedures and conversion to
total knee arthroplasty within 2 years after index meniscal surgery.
Results
Of the 1,383,161 patients with a diagnosis of meniscal tear, 53.0% underwent surgical
treatment. Surgical treatment consisted of meniscal debridement in 96.6% of patients
and meniscal repair in 3.4%. The percentage of meniscal repairs increased from 2.7%
to 4.4% over the 8-year period evaluated, whereas the percentage of meniscal debridement
decreased from 97.3% to 95.6% (P < .0001). Younger patients were more likely to undergo meniscal repair (23% of those
aged 10-19 years) than older patients (<1% of those aged ≥60 years). Among the 191,729
patients with International Classification of Diseases, Tenth Revision coding and 2-year follow-up, 10.6% of patients with index meniscal repair required
a revision meniscal operation and 1.2% underwent conversion to arthroplasty. Subsequent
meniscal procedures within 2 years after index meniscal repair included meniscal debridement
in 81.6% of patients and revision repair in 18.4%. Patients who initially underwent
meniscal debridement were less likely to undergo revision meniscal surgery (5.1%),
but 4.7% required conversion to arthroplasty. Patients aged 10 to 19 years were most
likely to undergo revision meniscal procedures after both index meniscal repair (12.8%)
and meniscal debridement (8.8%).
Conclusions
The rate of meniscal repair is increasing over time, with patients younger than 30
years most likely to undergo repair for a meniscal tear. Revision surgery for meniscal
repair or debridement is more common in adolescents and patients who undergo an index
meniscal repair.
Level of Evidence
Level III, retrospective cohort study.
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Article info
Publication history
Published online: June 07, 2022
Accepted:
April 27,
2022
Received:
December 29,
2021
See commentary on page 2884Footnotes
The authors report the following potential conflicts of interest or sources of funding: D.A.L. receives fellowship-related research grants from Arthrex and Smith & Nephew, outside the submitted work. B.T.F. is Associate Editor of Journal of Shoulder and Elbow Surgery; is Editor in Chief of Current Reviews in Musculoskeletal Medicine; receives research support from National Institutes of Health, US Department of Veterans Affairs, Orthofix, and Stryker; and owns stock in Bioniks and Kaliber.ai. C.B.M. receives research support from Anika, Histogenics, Samumed, and Zimmer; is a paid consultant for ConMed Linvatec, Histogenics, Medacta, Stryker, and Tornier; and receives publishing royalties from SLACK, outside the submitted work. A.L.Z. is a consultant for Stryker and DePuy Mitek, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
