2015 ISAKOS Biennial Congress ePoster #1365

Meniscal and Chondral Injuries Associated with Anterior Cruciate Ligament Tears: Relationship of Time from Injury and Giving Way Times

Yasunari Oniki, MD, PhD, Kamimashiki-Gun, Kumamoto JAPAN
Eiichi Nakamura, MD, PhD, Kumamoto, Kumamoto JAPAN
Hiroaki Nishioka, MD, PhD, Kumamoto City JAPAN

Kumamoto Kaiseikai Hospital, Kashima, Kumamoto, JAPAN

FDA Status Cleared

Summary: We investigated the relationship of time from injury and episdoes of giving way with the incidence of meniscal and chondral injuries after ACL tears. 145 knees underwent primary ACL reconstruction. Eighty seven cases (60%) had cartilage injuries and meniscal injuries were present in 114 cases (78%). Cartilage injuries were associated with longer wait times while meniscal injuries were associated w

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Abstract:

Background

Meniscal and chondral injuries concomitant to anterior cruciate ligament (ACL) tears are common and lead to a compromise of knee joint function. Especially, the chronically ACL-deficient knee is associated with an increased rate of medial meniscal and chondral injuries. However, the relationship with instability of the knee as giving way (GW) is not yet known.

Purpose

To investigate the relationship of GW with the incidence of meniscal and chondral injuries noted in each compartment. Additionally, the effect of the time from injury for ACL tears was also evaluated in young patients.

Methods

A retrospective arthroscopic charts review of 149 patients undergoing primary arthroscopic ACL reconstruction between January 2009 and February 2013 was performed. Exclusion criteria were over 45 years old, bilateral ACL tear, re-injury of reconstructed knee and having previous surgical history. A total of 145 knees (53 male and 92 female; average age at the time of surgery 21.2 ± 7.8 years) were underwent were included. The presence of meniscal tear, chondral injury, number of days from injury to treatment and number of times GW were recorded. The data were analyzed for associations between elapsed time before surgery as well as side to side differences in KT-1000 and GW with rates of meniscal and chondral injuries.

Results

Eighty seven cases (60%) had cartilage injuries: 79 (54%) in the medial femoral condyle, 35 (24%) in the lateral femoral condyle, 4 (3%) in the medial tibia condyle, and 6 (4% )in the lateral tibia condyle. Meniscal injuries were present in 114 cases (78%): 84 (58%) medial menisci and 76 (52%) lateral menisci. For time from injury, no patient was less than 3 weeks, 40 cases were from 3 weeks to 3 months, 72 cases were from three months to 12 months, 33 cases were more than 12 months. The only significant protective factor of cartilage injury was only the time from injury as less than 3 months (odds ratio [OR], 0.28; 95% confidence interval [CI], 0.12-0.65; p=0.0028). The strongest relationship was for the medial femoral condyle (OR 0.21; CI, 0.09-0.46; p=0.001). The only significant risk factor for meniscus injury was times GW (OR 1.33; CI, 1.02-1.74; p=0.038). No relationship was found between KT value and cartilage and/or meniscal injuries.

Conclusion

Cartilage damage was not increased with more times GW but with prolonged wait times until surgery. It appears cartilage damage was not caused by traumatic events, but accompanied degenerative changes in the knee after ACL injuries. On the other hand, meniscal injuries in ACL injuries appear to be caused by traumatic events or mechanical rotation instability.