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Multicenter Study
. 2012 Apr;40(4):808-14.
doi: 10.1177/0363546512437722. Epub 2012 Feb 28.

Association between previous meniscal surgery and the incidence of chondral lesions at revision anterior cruciate ligament reconstruction

Robert H Brophy  1 , Rick W Wright, Tal S David, Robert G McCormack, Jon K Sekiya, Steven J Svoboda, Laura J Huston, Amanda K Haas, Karen Steger-May; Multicenter ACL Revision Study (MARS) Group
Collaborators, Affiliations
Multicenter Study

Association between previous meniscal surgery and the incidence of chondral lesions at revision anterior cruciate ligament reconstruction

Robert H Brophy et al. Am J Sports Med. 2012 Apr.

Abstract

Background: Knees undergoing revision anterior cruciate ligament (ACL) reconstruction typically have more intra-articular injuries than do knees undergoing primary reconstruction.

Hypothesis: Previous partial meniscectomy (PM) is associated with a higher rate of chondral lesions at revision ACL reconstruction, whereas previous meniscal repair (MR) is not associated with a higher rate of chondral lesions at revision ACL reconstruction, compared with knees undergoing revision ACL with no previous meniscal surgery.

Study design: Cohort study (Prevalence); Level of evidence, 2.

Methods: Data from a multicenter cohort was reviewed to determine the history of prior meniscal surgery (PM/MR) and the presence of grade II/III/IV chondral lesions at revision ACL reconstruction. The association between previous meniscal surgery and the incidence of chondral lesions was examined. Patient age was included as a covariate to determine if surgery type contributes predictive information independent of patient age.

Results: The cohort included 725 ACL revision surgeries. Chondrosis was associated with patient age (P < .0001) and previous meniscal surgery (P < .0001). After adjusting for patient age, knees with previous PM were more likely to have chondrosis than knees with previous MR (P = .003) or no previous meniscal surgery (P < .0001). There was no difference between knees without previous meniscal surgery and knees with previous MR (P = .7). Previous partial meniscectomy was associated with a higher rate of chondrosis in the same compartment compared with knees without previous meniscal surgery (P < .0001) and knees with previous MR (P ≤ .03).

Conclusion: The status of articular cartilage at the time of revision ACL reconstruction relates to previous meniscal surgery independent of the effect of patient age. Previous partial meniscectomy is associated with a higher incidence of articular cartilage lesions, whereas previous meniscal repair is not. Although this association may reflect underlying differences in the knee at the time of prior surgery, it does suggest that meniscal repair is preferable when possible at the time of ACL reconstruction.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: The MARS study received funding from the AOSSM, Smith Nephew (Andover, Massachusetts), NFL Charities, and the Musculoskeletal Transplant Foundation (Edison, New Jersey).

Figures

Figure 1
Figure 1
Incidence of highest grade articular cartilage lesion in the knee by previous meniscal surgery. Statistical analysis: age, P < .0001; surgery, P < .0001; no surgery vs meniscal repair only, P = .74; no surgery vs debridement/partial meniscectomy, P < .0001; meniscal repair only vs debridement/partial meniscectomy, P = .003.
See this image and copyright information in PMC

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