2023 ISAKOS Biennial Congress ePoster
Delaying ACL Reconstruction Increases the Risk of Medial Meniscal Tear
Julien Erard, MD, Lyon FRANCE
Nicolas Cance, Resident, Lyon, Rhône-Alpes FRANCE
Jobe Shatrov, MD, Willoughby, NSW AUSTRALIA
Gaspard Fournier, MD, Aix En Provence FRANCE
Stanislas Gunst, MD, Lyon FRANCE
Gianluca Ciolli, MD ITALY
Pasquale Porcelli, MD, Alessandria ITALY
Sebastien Lustig, MD, PhD, Lyon, Rhône Alpes FRANCE
Elvire Servien, MD, PhD, Prof., Lyon, Rhône Alpes FRANCE
Croix-Rousse Hospital, LYON, Rhone, FRANCE
FDA Status Not Applicable
Summary
Delaying ACLR for more than 12 months significantly increased the rate of medial meniscal injury.
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Abstract
Purpose
Optimal timing between anterior cruciate ligament (ACL) injury and reconstruction (ACLR) remains debated. The aim of this study was to evaluate the relationship between the time from injury to ACLR and the rate as well as repairability of meniscal tears. Secondary aims of the study were to evaluate the relationship between meniscal injury and Tegner activity Scale (TAS), age, BMI, and gender.
Materials And Methods
Between 2012 to 2022, 1840 ACLR were performed. 1317 ACLR were included, with a mean age of 31.2 ±10.5 [16-60], a mean BMI of 24.3 ±3.7 [16.0-40.2]. The mean pre-operative TAS was 6.2±1.4 [1-10]. Meniscal tear was assessed during arthroscopy using ISAKOS classification. Rate of meniscus repair was also assessed. Delay to ACLR, TAS, age, BMI and gender were analyzed in uni- then multivariate analyses. Patients were divided in 4 groups according to the delay of the surgery: <3 months (427; 32%), 3 to 6 months (388; 29%), 6 to 12 months (248; 19%) and > 12 months (254; 19%).
Results
Delaying ACLR of more than 12 months significantly increased the rate of medial meniscal injury (OR 1.14; p=0.000). No correlation was found between a 3- or 6-month delay and medial meniscal tear. Delaying ACLR by more than 3, 6, or 12-month did not significantly increase the rate of lateral meniscal tear. No correlation was found between delaying ACLR by more than 3, 6, or 12-month and the rate of repairability of meniscal injury. Increasing TAS was significantly associated with a lower rate of medial meniscal injury (OR 0.90; p=0.020). An age>30 (OR 1.07; p=0.025) and male gender (OR 1.13; p<0.0001) were also associated with an increased rate of medial meniscal injury. An age>30 decreased the rate of medial meniscal suture (OR 0.85; p=0.000). Male gender increased the rate of meniscal tear (OR 1.10; p=0.001).
Conclusion.
Delaying ACLR beyond 12 months significantly increased the rate of medial meniscal tear without effecting the repairability of the tear. Increasing pre-injury TAS was associated with a decreased rate of medial meniscal tear. Age>30 increased the rate of medial meniscal tear and decreased the rate of repairability of medial meniscal tear.