Return to sport rate and activity level are high following arthroscopic all-inside meniscal repair with and without concomitant ACL reconstruction: a systematic review

Abstract Purpose The purpose of this investigation was to systematically review the literature of return to sport outcomes following all-inside meniscus repair and evaluate whether concomitant ACL reconstruction (ACLR) influenced these outcomes. Methods A systematic review of the MEDLINE, PubMed, Embase, and Cochrane Registry of Systematic Reviews databases was performed according to PRISMA guidelines. Two reviewers examined all literature pertaining to sport outcomes following all-inside meniscal repair. Studies were included if they had a 12 month minimum follow-up and reported return to sport rate, Tegner, or KOOS Sport outcomes . Studies with meniscal repair techniques other than the all-inside technique were excluded. Studies were not excluded if they contained patients receiving concomitant ACLR. Study quality was evaluated with the Methodological Index for Nonrandomized Studies (MINORS). Results Nineteen studies comprising 872 patients were included in this investigation. The weighted average patient age was 28.7 (range 14.1 - 42.1) years and the weighted average follow-up was 56.0 (range 18.0 - 155.0) months. The mean MINORS score was 14.4 ± 3.7. Ten investigations reported both preoperative (range 2.3 - 3.5) and postoperative (range 4.0 - 7.3) Tegner outcomes, with scores at final follow-up greater in each of the ten reporting investigations. KOOS Sport outcomes were examined in five investigations, with scores at follow-up ranging from 63.6 to 91. Three studies reported a return to sport rate ranging from 89.6 to 90% at follow-up. Four investigations compared sport-related outcomes between isolated meniscal repair and meniscal repair with concomitant ACLR. Two such studies reported no difference between the two cohorts, 1 favored the isolated cohort and 1 favored the combined cohort. Conclusion This systematic review found a 90% return to sport rate and high post-operative activity level following all-inside meniscal repair, as assessed by KOOS Sport and Tegner activity scales. Further, concurrent ACLR did not significantly affect these outcomes.