• PURPOSE
    • To investigate whether the treatment method of a concomitant lateral meniscus (LM) injury during primary anterior cruciate ligament (ACL) reconstruction (ACLR) affects ACL revision rates in football (soccer) players, nonfootball pivoting athletes and nonpivoting patients differentially, when compared to controls.
  • METHODS
    • Data from the Swedish Knee Ligament Registry (SKLR) from 2005 to 2022 were used in univariate and multivariate logistic regression. The study compared two groups: patients with isolated ACLR and patients with ACLR and concomitant LM injury. These groups were further divided into activity type during injury (football, nonfootball pivoting and nonpivoting), as well as meniscal treatment type (repair, resection and left in situ). The outcome of interest was the ipsilateral ACL revision rate at 5 and 10 years after primary ACLR, when comparing the LM treatments among different activities at the time of injury.
  • RESULTS
    • Five-year data were available for 21,848 patients, and 10-year data were available for 10,827 patients. Football players had higher odds of revision ACLR at 5 (odds ratio [OR]: 1.51 [1.34-1.72]; p < 0.0001) and 10 years (OR: 1.51 [1.27-1.79]; p < 0.0001). When compared to isolated ACLR in nonfootball pivoting athletes, nonfootball pivoting athletes with concomitant LM injury left in situ had higher odds of revision ACLR at 5 years (OR: 1.87 [1.07-3.30]; p = 0.0029) and 10 years (OR: 2.50 [1.18-5.29]; p = 0.017). Additionally, nonpivoting patients with concomitant LM injury left in situ had higher odds of revision ACLR at 10 years (OR: 2.34 [1.03-5.34]; p = 0.043) compared to nonpivoting patients undergoing isolated ACLR. Repair or resection of LM injuries were not associated with increased rates of revision ACLR in any of the study groups (p > 0.05).
  • CONCLUSIONS
    • LM tears left untreated increased the odds of revision ACLR in nonfootball playing patients in the current study. However, in football players, who were observed to have increased odds of failure, there were no significant associations between LM management and revision ACLR.
  • LEVEL OF EVIDENCE
    • Level III.