The evaluation of patient-specific factors associated with meniscal and chondral injuries accompanying ACL rupture in young adult patients

Abstract

Purpose: To evaluate patient-specific factors, including the mechanism of injury, time from the injury, activity level after the initial trauma, re-injury and body mass index (BMI), as risk factors for meniscal and chondral injuries accompanying anterior cruciate ligament (ACL) rupture.

Methods: A retrospective review of young adult patients with complete ACL rupture was performed between 2007 and 2011. The presence of meniscal tears and/or chondral injury, and the mechanism of injury, time from the injury, activity level after the initial trauma, re-injury and BMI were recorded. The data were analysed for associations between patient-specific factors and the prevalence of meniscal and chondral injuries.

Results: A total of 293 patients were included. Increasing time from the injury, active daily life and re-injury were risk factors associated with meniscal injuries (p < 0.05). Independent risk factors associated with meniscal injuries included active daily life (OR = 4.66, 95 % CI 2.21-9.86, p < 0.0001) and re-injury (OR = 7.68, 95 % CI 3.24-18.22, p < 0.0001). Contact injury, increasing time from the injury, active daily life and re-injury were risk factors associated with chondral injuries (p < 0.05). Independent risk factors associated with chondral injuries included contact injury (OR = 2.54, 95 % CI 1.27-5.10, p < 0.01), active daily life (OR = 2.62, 95 % CI 1.35-5.08, p < 0.01) and re-injury (OR = 4.18, 95 % CI 2.09-8.35, p < 0.001). The incidence of re-injury was associated with the activity level (p < 0.001) and increased with increasing time from the injury (r = -0.698, p < 0.001).

Conclusions: An increased risk of meniscal tear (especially medial meniscus) was strongly associated with an active daily life and re-injury. The combination of contact injury, active daily life and re-injury substantially increased the risk of cartilage injury. Patients with increasing time from the injury and active daily life exhibited a higher risk of re-injury, implying a higher prevalence of intra-articular damage.