Increasing meniscal repair rates during ACL reconstruction did not increase reoperation risk: An analysis of surgical trends from 2015 to 2023

PURPOSE: To evaluate surgical trends over time in meniscal procedures during anterior cruciate ligament reconstruction (ACLR) and compare meniscal reoperation rates and subjective outcomes between 2015-2019 and 2020-2023. METHODS: . Subgroup analysis compared reoperation rates following medial, lateral and combined medial and lateral meniscal procedures. RESULTS: The proportion of meniscal repairs increased (18.0%-30.2%, p < 0.001), whereas meniscal resections decreased (21.1%-15.1%, both p < 0.001) from 2015-2019 to 2020-2023. Meniscal reoperation rates did not differ significantly between cohorts for repairs (9.0% vs. 11.4%, p = not significant (n.s.)) or resections (5.0% vs. 3.9%, p = n.s.). Combined medial and lateral meniscal procedures had significantly higher meniscal reoperation rates overall (11.7%) compared to medial (6.5%) and lateral (7.8%) meniscal procedures (p < 0.001). Lateral meniscal resections resulted in significantly more reoperations (2.8%) compared to medial (1.4%) and combined (1.5%) meniscal resections (p = 0.04) within the full cohort. There were no significant differences between cohorts in MIC, PASS, or TF. Multivariable analysis showed lower odds of reoperation in 2020-2023 compared to 2015-2019 (odds ratio [OR] = 0.39; 95% confidence interval [CI] 0.26-0.60; p < 0.001). CONCLUSION: Meniscal repair rates during ACLR increased significantly over time, while short-term reoperation rates and patient-reported outcomes remained unchanged. These findings align with the increasing emphasis on meniscal preservation in clinical practice. LEVEL OF EVIDENCE: Level III.