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. 2023 Sep 8;11(9):23259671231196492.
doi: 10.1177/23259671231196492. eCollection 2023 Sep.

Risk Factors for Concomitant Meniscal Injury With Sport-Related Anterior Cruciate Ligament Injury

Hailee Reist  1 , Pamela M Vacek  2 , Nathan Endres  1 , Timothy W Tourville  3 , Mathew Failla  3 , Andrew Geeslin  1 , Matthew Geeslin  4 , Andy Borah  1 , Mickey Krug  1 , Rebecca Choquette  1 , Mike Toth  1   5 , Bruce D Beynnon  1
Affiliations

Risk Factors for Concomitant Meniscal Injury With Sport-Related Anterior Cruciate Ligament Injury

Hailee Reist et al. Orthop J Sports Med. .

Abstract

Background: Previous studies of concomitant meniscal injury in athletes with anterior cruciate ligament (ACL) injury have examined age, sex, body mass index (BMI), injury mechanism, and time from injury to surgery as potential risk factors.

Purpose: To identify additional risk factors for concomitant meniscal injury, including preinjury joint laxity and lower extremity alignment, in athletes with sport-related ACL injury.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: This study included 180 participants aged 13 to 26 years who underwent ACL reconstruction (ACLR) after a first-time ACL injury sustained during participation in sport. Contralateral lower extremity alignment and joint laxity were used as surrogate measures for the injured knee before trauma. Concomitant meniscal tear patterns were identified at the time of ACLR. Sex-specific analyses were conducted.

Results: Concomitant meniscal injury was observed in 60.6% of the subjects. The prevalence of concomitant injury was higher in male than female participants (69.9% vs 54.2%; P = .035) due to a higher prevalence of lateral meniscal injuries (56.2% vs 38.3%; P = .018). Among male patients, there was a significant difference in the prevalence of concomitant lateral meniscal tear according to sport participation (≥9 vs <9 h/week: 67.4% vs 35.7%; P = .032). Among male patients, the likelihood of concomitant injury to both the lateral and medial menisci increased by 28.8% for each 1-mm decrease in navicular drop. Among female patients, the likelihood of concomitant injury to the lateral meniscus increased by 15% per degree increase in genu recurvatum and 14% per degree decrease in standing quadriceps angle, with similar effects on the likelihood of concurrent injury to both the lateral and medial menisci.

Conclusion: Measures of lower extremity alignment and genu recurvatum previously identified as risk factors for ACL injury were also associated with concomitant meniscal injury in female patients while other risk factors, including BMI and joint laxity, were not. Increased time spent participating in sport and navicular drop were associated with concomitant meniscal injury in male patients.

Keywords: anterior cruciate ligament; knee; meniscus; risk factors; trauma.

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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: this investigation was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the United States National Institutes of Health (grant RO1 AR050421). A.G. has received education payments from Arthrex, consulting fees from Smith & Nephew, nonconsulting fees from Arthrex and Smith & Nephew, and hospitality payments from Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
CONSORT flowchart of patient inclusion. ACL, anterior cruciate ligament; ACLR, ACL reconstruction; CONSORT, Consolidated Standards of Reporting Trials; IKDC, International Knee Documentation Committee.
See this image and copyright information in PMC

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