Abstract
Background:
Treating lateral meniscal injuries in elite athletes is challenging because of the high demands on knee function and the need for rapid return to play (RTP). Although meniscal repair is often recommended, data are lacking that compare outcomes of partial meniscectomy and repair in elite athletes with isolated lateral meniscal tears.
Purpose:
To evaluate subsequent surgery after the treatment of isolated lateral meniscal tears and to compare RTP, career longevity, and performance level between meniscal repair and partial meniscectomy in professional soccer players.
Study Design:
Retrospective case comparative study; Level of evidence, 3.
Methods:
A retrospective review was conducted on a consecutive series of professional soccer players who underwent partial meniscectomy or meniscal repair for isolated lateral meniscal tears between January 2011 and September 2022 with a minimum follow-up of 2 years. The groups were compared for age, tear configuration, tear location, subsequent surgery, RTP rates, career longevity, and performance level. Repair failure was defined as the need for additional surgery to address a recurrent or persistent meniscal tear after the initial repair or not returning to play. Cox proportional hazards models were used to evaluate career longevity based on treatment modality, adjusting for age.
Results:
This study included 89 professional soccer players (mean ± SD age, 23.2 ± 5.2 years) who underwent primary isolated lateral meniscal surgery: 49 (55.1%) had partial meniscectomy and 40 (44.9%) underwent repair. Subsequent surgery was required in 15 players (16.9%), with no significant difference between groups (12.2% for meniscectomy vs 22.5% for repair; P = .258). Meniscal repair failure occurred in 6 players (15%), with a mean time to failure of 8.6 ± 8.2 months. RTP was achieved by 98.9% of the total cohort, but meniscectomy led to faster RTP (median, 4 months; range, 0.5-20) than repair (median, 6 months; range, 3-22; P < .001). No significant difference was found in early retirement risk (hazard ratio, 0.65; 95% CI, 0.31-1.3; P = .237) when adjusted for age. At 5 years, retirement rates were 28% (repair) and 32.6% (meniscectomy; P = .789), rising to 45.5% and 58.3% at 10 years (P = .716). Most players (70% for repair and 89% for meniscectomy) returned to the same or higher league, declining to 48.6% and 51.1% at 2 years and 36% and 20.9% at 5 years (P > .05).
Conclusion:
Partial meniscectomy and repair achieve high RTP rates, with meniscectomy allowing a faster RTP. While 15% of meniscal repairs failed, rates of subsequent surgery and 5- and 10-year professional sport participation did not differ significantly from those after partial meniscectomy, although the lack of statistical significance may be due to the limited sample size. Hence, partial meniscectomy for isolated lateral meniscal tears may be acceptable in carefully selected patients with proper management and recovery.
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