Understanding the specific risks of ACL surgery is key to improving outcomes and avoiding complications.
Recent data from a large-scale French study highlights who is most at risk of developing a posterior root tear of the lateral meniscus (LMPRT) during ACL reconstruction. This article summarises the findings of the study “Male Sex, Revision Surgery, Low Volume of Anterior Cruciate Ligament Remnant, and Significant Instability Are Risk Factors for Posterior Root Tear of the Lateral Meniscus in Patients Undergoing Anterior Cruciate Ligament Reconstruction”. For a complete understanding of the data and methodology, we recommend reading the full publication.
The posterior root of the lateral meniscus anchors the meniscus to the tibia. A tear in this region can compromise knee stability and accelerate joint degeneration. While such tears are sometimes detected during ACL surgery, identifying the patients most at risk has been a topic of research.
The study, which analysed over 5,000 ACL reconstructions from the Francophone Arthroscopic Society’s registry, sheds light on several predictive factors for LMPRTs.
According to the data, men are statistically more likely to sustain a lateral meniscal posterior root tear during ACL surgery. The study also found that patients undergoing a revision ACL surgery—meaning they had already undergone one ACL reconstruction in the past—were significantly more at risk of experiencing this complication.
The pivot shift test, used to assess rotational instability of the knee, was another indicator. A greater pivot shift score (meaning more noticeable knee instability) was strongly associated with the presence of LMPRTs.
Interestingly, the volume of remaining ACL fibres also played a role. Patients with a low volume of ACL remnant tissue (especially less than 10%) were more likely to suffer an LMPRT. This could suggest that the absence of residual ligament fibres increases mechanical stress on the meniscal structures.
Although the delay between injury and surgery was evaluated, no significant difference was observed between groups. Age and collateral ligament injuries did not emerge as statistically significant risk factors in this study.
These findings were confirmed using multivariate analysis, strengthening the reliability of the results.
To explore all numerical data, statistical methods and clinical implications, refer to the complete study.
Implications for clinical practice
For surgeons and patients alike, these insights are valuable. Knowing the risk profile helps in preoperative planning, patient counselling and potentially in adopting protective strategies during surgery.
In particular, greater attention should be paid to patients who:
This could influence the surgical technique, rehabilitation timeline, or post-operative monitoring protocols.
If you are interested in the latest ACL research or planning an anterior cruciate ligament reconstruction, consider browsing the other scientific publications available on Professor Cavaignac’s website.
With over 1,000 knee surgeries performed each year and more than 150 publications to his name, Professor Etienne Cavaignac offers unparalleled expertise in knee surgery and sports traumatology. His research and clinical practice are fully aligned to provide each patient with precise, personalised care based on the latest evidence.
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