Association of Meniscus Injuries in Patients With Anterior Cruciate Ligament Injuries.

Abstract

Introduction: In today's orthopaedic practice, meniscus and anterior cruciate ligament (ACL) injuries are prevalent. It is more common in sports injuries and automobile accidents. In patients with ACL tears, meniscus problems are also common. Several studies have linked meniscus injuries to the development of osteoarthritis in early stages. Early onset of osteoarthritis has been observed in ACL-repaired patients with meniscus tears. As a result, meniscus tears should be detected and corrected as soon as possible to avoid degenerative changes in the knee joint. The goal of the study was to see if there was a link between meniscus injuries and ACL injuries in our rural community.Methods: This retrospective study was conducted on 48 patients at the R.L. Jalappa Hospital & Research Centre from January 2012 to December 2019. Patients between the ages of 18-65 diagnosed with ACL tear with/without meniscus damage in their knees were included in the study. Patients with posterior cruciate ligament (PCL) tear, medial collateral ligament (MCL) or lateral collateral ligament (LCL) injury, previously operated index knees, and patients with more than grade 3 knee osteoarthritis (Kellgren and Lawrence classification) were excluded. Clinical assessment of patients with knee injuries, MRI and diagnostic arthroscopy of the knee joint details were collected. After obtaining the data, we estimated the incidence of meniscus injuries associated with chronic ACL injuries. We also calculated the percentage of side/laterality injury (medial meniscus or lateral meniscus) and part of meniscus injury (anterior horn, body, and posterior horn) in chronic ACL-deficient knees. Patient characteristics such as age and gender were correlated with functional knee assessment using a modified Lysholm score. P-value and chi-square tests were used to assess the data. P-value of less than 0.5 was considered significant.Results: Average age of the participants was 32.31 years. There were 42 men and six women in the group. Isolated medial meniscus, lateral meniscus, and combined medial and lateral meniscus had average ages of 31.83, 31.16, and 40.28 years, respectively. ACL injuries on the right side were seen in 23 patients the left side was seen in 25 patients. In comparison to the right side, the isolated medial meniscus injury on the left side was more severe. In case of a combination of medial and lateral meniscus tears, the right side suffered more damage than the left. Eleven patients had an isolated ACL tear without a meniscus injury, while the other 37 had a meniscus injury and an ACL tear. Excellent scores were observed in 11 cases, satisfactory scores in 26, and unsatisfactory in 11 cases. Age group was categorized into three groups, less than 30, 30-45, and more than 45 years. Excellent, satisfactory, and unsatisfactory scores were observed in seven, eleven, and seven patients on the left side and excellent, satisfactory, and unsatisfactory scores in four, fifteen, and four patients on the right side, respectively. P-value was not statistically significant when comparing outcomes by age, gender, or side.Conclusion: Meniscus injuries occurred 77% of the time when there was a persistent ACL injury. In comparison to a lateral meniscus injury, the incidence of medial meniscus injury associated with chronic ACL tear was higher. In comparison to the anterior horn and body of the medial meniscus, the majority of medial meniscus tears were found in the posterior horn.