Abstract

To determine the association between a delay in anterior cruciate ligament reconstruction (ACLR), age, sex, body mass index (BMI) and cartilage injuries, meniscus injuries, meniscus repair, and abnormal prereconstruction laxity. Patients who underwent primary ACLR at our institution from January 2005 to March 2017, with no associated ligament injuries, were identified. Logistic regression analyses were used to evaluate whether delay in ACLR, age,sex, and BMI were risk factors for cartilage and meniscus injuries, meniscus repair, and abnormal (side-to-side difference >5 mm) prereconstruction laxity. A total of 3976 patients (mean age 28.6 ± 10.6 years, range 10-61 years) were included. The risk of cartilage injury increased with a delay in ACLR (12-24 months: odds ratio [OR] 1.20; 95% confidence interval [CI] 1.05-1.29; P= .005; and > 24 months: OR 1.20; 95% CI 1.11-1.30; P < .001) and age ≥30 years (OR 2.27; 95% CI 1.98-2.60; P < .001). The risk of medial meniscus (MM) injury increased with a delay in ACLR (12-24 months: OR 1.20; 95% CI 1.07-1.29; P= .001; and >24 months: OR 1.22; 95% CI 1.13-1.30; P < .001), male sex (OR 1.16; 95% CI 1.04-1.30; P= .04) and age ≥30 years (OR 1.20; 95% CI 1.04-1.33; P= .008). The risk of lateral meniscus (LM) injury decreased with a delay in ACLR of >3 months and age ≥30 years (OR 0.75; 95% CI 0.66-0.85; P<.001), whereas it increased with male sex (OR 1.32; 95% CI 1.22-1.41; P < .001). MM repairs relative to MM injury decreased with a delay in ACLR (6-12 months: OR 0.70; 95% CI 0.54-0.92; P= .01; 12-24 months: OR 0.69; 95% CI 0.57-0.85; P < .001; >24 months: OR 0.61; 95% CI 0.52-0.72; P < .001) and age ≥30 years (OR 0.60; 95% CI 0.48-0.74; P<.001). LM repairs relative to LM injury only decreased with age ≥30 years (OR 0.34; 95% CI 0.26-0.45; P < .001). The risk of having abnormal knee laxity increased with a delay in ACLR of >6 months and MM injury (OR 1.52; 95% CI 1.16-1.97; P= .002), whereas it decreased with a BMI of ≥25 (OR 0.68; 95% CI 0.52-0.89; P= .006). A delay in ACLR of >12 months increased the risk of cartilage and MM injuries, whereas a delay of >6 months increased the risk of abnormal prereconstruction laxity and reduced the likelihood of MM repair. To reduce meniscus loss and the risk of jeopardizing knee laxity, ACLR should be performed within 6 months after the injury. Level III, retrospective therapeutic comparative study.

Highlights

  • An intact anterior cruciate ligament (ACL) imparts anterior and rotatory stability to the knee and prevents abnormal shear stresses across cartilage and menisci.[1]

  • Cartilage and Meniscus Injuries A delay in anterior cruciate ligament reconstruction (ACLR) of >12 months increased the odds of cartilage injuries and medial meniscus (MM) injuries, whereas a delay of >3 months reduced the odds of lateral meniscus (LM) injuries

  • Male sex increased the odds of MM and LM injuries

Read more

Summary

Introduction

An intact anterior cruciate ligament (ACL) imparts anterior and rotatory stability to the knee and prevents abnormal shear stresses across cartilage and menisci.[1]. The authors report that they have no conflicts of interest in the authorship and publication of this article. Another concern regarding delayed ACLR is the possible negative effect on joint kinematics. Persistent pathologic laxity due to ACL deficiency could affect other joint structures over time, leading to the progressive stretching of the secondary knee stabilizers.[14] the potential benefits of early ACLR in reducing the possible effects of this change in kinematics are poorly studied

Objectives
Methods
Results
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.