{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:12:28Z","timestamp":1779451948474,"version":"3.53.1"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate failure rates across specific meniscal tear morphologies in patients undergoing all\u2010inside meniscal repair with anterior cruciate ligament reconstruction (ACLR), and to identify factors associated with failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort included 1355 patients who underwent all\u2010inside meniscal repair during ACLR between 2015 and 2022 at Capio Artro Clinic, Stockholm, Sweden. Failure was defined as reoperation within 3 years. Tear morphology, meniscal laterality, age and sex were recorded. Kaplan\u2013Meier (KM) analysis assessed survival, and Cox regression identified factors associated with failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 3\u2010year failure rate was 12.3%. Medial repairs failed significantly more than lateral repairs (17.7% vs. 5.3%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with lower medial survival on KM analysis (log rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Bucket handle tears had the highest failure rate (18.6%), followed by undersurface (15.6%) and longitudinal tears (11.2%). Root (6.1%) and radial tears (RTs) (5.6%) had the lowest. In multivariable analysis, medial repair was the strongest predictor of failure (hazard ratio [HR] 3.08, 95% confidence interval [CI] 2.03\u20134.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Longitudinal tears had lower failure risk than bucket handle tears (HR 0.67, 95% CI 0.57\u20130.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Female sex increased failure risk (HR 1.38, 95% CI 1.02\u20131.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), while age &gt;30 years was not associated with failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Meniscal repair performed during ACL reconstruction demonstrated a 12.3% failure rate at 3 years. Failure risk differed by tear morphology and meniscal side, with medial repairs and bucket\u2011handle tears showing the highest risk, while root and RTs showed the lowest. Female sex was independently associated with increased failure, whereas age was not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ksa.70457","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:52:50Z","timestamp":1779450770000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bucket\u2010handle and medial meniscal tears exhibit higher failure rates after all\u2010inside repair with concomitant ACL reconstruction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-3267","authenticated-orcid":false,"given":"Christoffer","family":"von Essen","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Sports Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Stockholm Sports Trauma Research Center (SSTRC) FIFA Medical Centre of Excellence Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Cristiani","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Sports Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Stockholm Sports Trauma Research Center (SSTRC) FIFA Medical Centre of Excellence Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dzan","family":"Rizvanovic","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Sports Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Stockholm Sports Trauma Research Center (SSTRC) FIFA Medical Centre of Excellence Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"W\u00e4nman","sequence":"additional","affiliation":[{"name":"Department of Diagnostics and Intervention, Orthopaedics Ume\u00e5 University Hospital Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"St\u00e5lman","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Section of Sports Medicine Karolinska Institutet Stockholm Sweden"},{"name":"Stockholm Sports Trauma Research Center (SSTRC) FIFA Medical Centre of Excellence Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"issue":"13","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"3386","DOI":"10.1177\/0363546520906141","article-title":"All\u2010inside repair of bucket\u2010handle meniscal tears: clinical outcomes and prognostic factors","volume":"48","author":"Ardizzone CA","year":"2020","journal-title":"Am J Sports Med"},{"issue":"6","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1177\/03635465211015425","article-title":"What is the failure rate after arthroscopic repair of bucket\u2010handle meniscal tears? A systematic review and meta\u2010analysis","volume":"50","author":"Costa GG","year":"2022","journal-title":"Am J Sports Med"},{"issue":"1","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s00167-022-07135-8","article-title":"High prevalence of meniscal ramp lesions in anterior cruciate ligament injuries","volume":"31","author":"Cristiani R","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"8","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1016\/j.arthro.2018.03.038","article-title":"Risk factors for abnormal anteroposterior knee laxity after primary anterior cruciate ligament reconstruction","volume":"34","author":"Cristiani R","year":"2018","journal-title":"Arthroscopy"},{"issue":"4","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1016\/j.arthro.2020.11.030","article-title":"Delayed anterior cruciate ligament reconstruction increases the risk of abnormal prereconstruction laxity, cartilage, and medial meniscus injuries","volume":"37","author":"Cristiani R","year":"2021","journal-title":"Arthroscopy"},{"issue":"2","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1177\/0363546517737054","article-title":"Medial meniscus resection increases and medial meniscus repair preserves anterior knee laxity: a cohort study of 4497 patients with primary anterior cruciate ligament reconstruction","volume":"46","author":"Cristiani R","year":"2018","journal-title":"Am J Sports Med"},{"issue":"6","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1177\/0363546516686968","article-title":"Outcomes after biologically augmented isolated meniscal repair with marrow venting are comparable with those after meniscal repair with concomitant anterior cruciate ligament reconstruction","volume":"45","author":"Dean CS","year":"2017","journal-title":"Am J Sports Med"},{"issue":"9","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"2390","DOI":"10.1177\/03635465221101136","article-title":"Surgical outcomes after bucket\u2010handle meniscal repairs: analysis of a large contained cohort","volume":"50","author":"Ding DY","year":"2022","journal-title":"Am J Sports Med"},{"issue":"9","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1016\/j.arthro.2024.01.021","article-title":"All\u2010inside and inside\u2010out repair techniques for bucket\u2010handle meniscus tears both result in improved patient outcomes and a broad range of failure rates: a systematic review","volume":"40","author":"Dzidzishvili L","year":"2024","journal-title":"Arthroscopy"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12780"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.70026"},{"issue":"2","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/03635465231216364","article-title":"Incidence of and risk factors for medial meniscal lesions at the time of ACL reconstruction: an analysis of 4697 knees from the SANTI study group database","volume":"52","author":"Giurazza G","year":"2024","journal-title":"Am J Sports Med"},{"issue":"7","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1007\/s00167-021-06787-2","article-title":"Long\u2010term follow\u2010up of bucket\u2010handle meniscal repairs: chondroprotective effect outweighs high failure risk","volume":"30","author":"Kalifis G","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"11","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"2262","DOI":"10.1097\/CORR.0000000000000464","article-title":"Tibiofemoral contact mechanics with horizontal cleavage tears and treatment of the lateral meniscus in the human knee: an in vitro cadaver study","volume":"476","author":"Koh JL","year":"2018","journal-title":"Clin Orthop Relat Res"},{"issue":"4","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1007\/s00167-020-05847-3","article-title":"Management of traumatic meniscus tears: the 2019 ESSKA meniscus consensus","volume":"28","author":"Kopf S","year":"2020","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"1","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.csm.2019.08.007","article-title":"Meniscus form and function","volume":"39","author":"Markes AR","year":"2020","journal-title":"Clin Sports Med"},{"issue":"8","key":"e_1_2_11_18_1","doi-asserted-by":"crossref","DOI":"10.1177\/23259671251361488","article-title":"All\u2010inside versus inside\u2010out suture techniques in athletes undergoing arthroscopic meniscal repair: a systematic review and meta\u2010analysis","volume":"13","author":"Miller AC","year":"2025","journal-title":"Orthop J Sports Med"},{"issue":"14","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.2106\/JBJS.21.01303","article-title":"Meniscal repair outcomes at greater than 5 years: a systematic review and meta\u2010analysis","volume":"104","author":"Nepple JJ","year":"2022","journal-title":"J Bone Jt Surg"},{"issue":"7","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1016\/j.arthro.2024.10.050","article-title":"Lower surgical volume reduces the odds of performing meniscus repair for tears during primary anterior cruciate ligament reconstruction","volume":"41","author":"Rizvanovic D","year":"2025","journal-title":"Arthroscopy"},{"issue":"3","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.1177\/2325967120905529","article-title":"Predictive factors for failure of meniscal repair: a retrospective dual\u2010center analysis of 918 consecutive cases","volume":"8","author":"Ronnblad E","year":"2020","journal-title":"Orthop J Sports Med"},{"issue":"11","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"3048","DOI":"10.3390\/jcm13113048","article-title":"Bucket\u2010handle meniscal tears might not be an urgency: the time to meniscus repair does not seem to affect the mid\u2010term outcome\u2010a retrospective study of sixty tears with a mean follow\u2010up of 6 years","volume":"13","author":"Schippers P","year":"2024","journal-title":"J Clin Med"},{"issue":"3","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1177\/03635465231158385","article-title":"Meniscal repair outcome in 3829 patients with a minimum follow\u2010up from 2 years up to 5 years: a meta\u2010analysis on the overall failure rate and factors influencing failure","volume":"52","author":"Schweizer C","year":"2024","journal-title":"Am J Sports Med"},{"issue":"7","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1007\/s00167-021-06770-x","article-title":"Nineteen percent of meniscus repairs are being revised and failures frequently occur after the second postoperative year: a systematic review and meta\u2010analysis with a minimum follow\u2010up of 5 years","volume":"30","author":"Schweizer C","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"10","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"3350","DOI":"10.3390\/jcm14103350","article-title":"Saving the meniscus: a retrospective observational study of the incidence, treatment, and failure rate of the main meniscal tear types at 24\u2010month follow\u2010up","volume":"14","author":"Screpis D","year":"2025","journal-title":"J Clin Med"},{"issue":"4","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1177\/0363546514522394","article-title":"Hidden lesions of the posterior horn of the medial meniscus: a systematic arthroscopic exploration of the concealed portion of the knee","volume":"42","author":"Sonnery\u2010Cottet B","year":"2014","journal-title":"Am J Sports Med"},{"issue":"7","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1177\/03635465211006103","article-title":"Ramp lesion subtypes: prevalence, imaging, and arthroscopic findings in 2156 anterior cruciate ligament reconstructions","volume":"49","author":"Thaunat M","year":"2021","journal-title":"Am J Sports Med"},{"issue":"3","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","DOI":"10.1177\/2325967121989678","article-title":"Clinical, radiographic, and arthroscopic outcomes of surgical repair for radial and avulsed lesions on the lateral meniscus posterior root during ACL reconstruction: a systematic review","volume":"9","author":"Zheng T","year":"2021","journal-title":"Orthop J Sports Med"},{"issue":"8","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"612","DOI":"10.5312\/wjo.v14.i8.612","article-title":"Failure rate, return\u2010to\u2010sports and magnetic resonance imaging after meniscal repair: 119 patients with 7 years mean follow up","volume":"14","author":"Zicaro JP","year":"2023","journal-title":"World J Orthop"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70457","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ksa.70457","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ksa.70457","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T11:52:54Z","timestamp":1779450774000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/ksa.70457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":28,"alternative-id":["10.1002\/ksa.70457"],"URL":"https:\/\/doi.org\/10.1002\/ksa.70457","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"assertion":[{"value":"2026-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ksa.70457"}}