Abstract
This article aims to evaluate factors associated with chondral and meniscal lesions
in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions
from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic
regression was used to estimate the association between chondral and meniscal injuries
and age, gender, tear chronicity, additional ligamentous injuries, sport type, and
participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary
reconstructions and 9.6% were revisions. Meniscal injuries were significantly lower
in the revision group (44.0 vs. 51.9%; p = 0.01), while chondral injuries were significantly higher in the revision group
(39.9 vs. 24.0%; p < 0.0001). Inspection of the small subgroup (n = 85) receiving both primary and revision ACL surgery at our center indicated that
meniscal injuries at revision were evenly split between menisci with and without previous
repairs, whereas the vast majority of Grade III and IV chondral lesions were new.
More patients presented for surgery later in the revision group than in the primary
group (56.5 vs. 35.3%; p < 0.0001). Male gender, primary reconstruction, and short interval (less than 2 weeks)
between injury and surgery were associated with increased likelihood of meniscus tear.
Age (greater than 22 years) and long interval (greater than 6 weeks) between injury
to surgery and higher sport activity level were associated with chondral lesions.
Revision ACL reconstructions are associated with a higher proportion of chondral lesions
and a lower proportion of meniscal tears. Early primary and revision ACL construction
is recommended to reduce the probability of chondral lesions.
Keywords
ACL reconstruction - ACL revision - meniscus - chondral lesion - cartilage
