Medial meniscal and chondral pathology at the time of revision anterior cruciate ligament reconstruction results in inferior mid-term patient-reported outcomes View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-03-07

AUTHORS

Kate E. Webster, Julian A. Feller, Alexander Kimp, Brian M. Devitt

ABSTRACT

PurposeAnterior cruciate ligament (ACL) injuries are frequently not isolated injuries and damage to the menisci and articular cartilage surfaces is common. The concomitant presence of meniscal and chondral damage has the potential to influence patient outcomes following ACL reconstruction surgery and especially following revision ACL reconstruction where these findings are more common. However, study results regarding the mid-term outcome have been inconsistent. The purpose of this study was to compare mid-term patient-reported outcomes and return to sport in patients with and without meniscal and chondral pathology at the time of revision ACL reconstruction surgery.MethodsA cohort of 180 patients (131 males, 49 female) with a mean age of 25.3 (SD 7.8) years participated at an average follow-up time of 4.6 (SD 1.3) years after revision ACL reconstruction surgery. All patients completed the IKDC Subjective, Marx Activity, KOOS-Quality of Life (QOL) and Single Numerical Assessment (SANE) scores. In addition, patients were asked to indicate the highest level of sport to which they had returned following their revision surgery. Any further injuries to either knee were also documented. Patients were grouped according to whether or not they had medial or lateral meniscal pathology at the time of revision surgery; and whether or not they had > 50% depth chondral damage (ICRS 3 or 4). All outcomes were compared between these groupings.ResultsPatients with medial meniscal pathology had significantly lower Marx, KOOS-QOL and SANE scores than patients without. There were no differences in any outcome score between patients with and without lateral meniscal pathology. Patients with ICRS 3 or 4 chondral pathology had significantly lower scores on all patient-reported outcomes as well as a lower rate of return to the same level of pre-injury sport.ConclusionThe presence of more severe chondral damage at the time of revision ACL reconstruction has a negative impact on functional outcomes, activity levels and return to sport rates. In addition, the presence of medial meniscal pathology was associated with significantly lower functional and quality of life scores than patients without pathology. These findings provide important clinically relevant data on the outcomes following revision ACL reconstruction with concomitant chondral and meniscal injury.Level of evidenceIII. More... »

PAGES

1059-1064

References to SciGraph publications

  • 2011-11-08. Patients with focal full-thickness cartilage lesions benefit less from ACL reconstruction at 2–5 years follow-up in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2015-07-23. Revision anterior cruciate ligament reconstruction: clinical outcome and evidence for return to sport in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2015-08-19. Meniscal tears associated with anterior cruciate ligament injury in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2010-07-20. Causes for failure of ACL reconstruction and influence of meniscectomies after revision in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-04-09. Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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    http://dx.doi.org/10.1007/s00167-018-4880-z

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    https://app.dimensions.ai/details/publication/pub.1101378675

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    https://www.ncbi.nlm.nih.gov/pubmed/29516122


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