Early chondral damages following meniscus repairs with anterior cruciate ligament reconstructions

Abstract

Purpose: Early chondral damages following the meniscal repair with anterior cruciate ligament (ACL) reconstruction is unclear. The purpose of this study was to evaluate the zone-specific chondral damages after arthroscopic meniscus repair concomitant with ACL reconstruction. Methods: This study included 42 patients that underwent anatomic double-bundle ACL reconstruction. A second-look arthroscopy was performed at a mean of 16 months postoperatively. We divided the patients into two groups: group A with intact meniscus (22 knees) and group M with meniscus repair (20 knees). No significant difference was observed in patient demographics (Table 1). The surface of knee articular cartilage was divided into 40 sub-compartments as shown in Figure 1. Chondral damages were evaluated arthroscopically in the 40 sub-compartments using International Cartilage Repair Society (ICRS) classification. The same score, as evaluated in the ICRS grade, was given to the sub-compartment. The sub-compartment score was compared between two groups. Clinical outcomes at the final follow-up (average, 30 months) were compared between two groups. Results: The average sub-compartment score at reconstruction in both groups was shown in Figure 2. Significant worsening was noted at the 5 sub-compartments located in the central part of the medial tibiofemoral compartment in group M. The average sub-compartment score at second-look arthroscopy in both groups was shown in Figure 3. Significant worsening was also observed at 9 sub-compartments located in the central part of patella and bilateral tibiofemoral compartment in group M. All clinical scores at the final follow-up were lower in group M than in group A (P > 0.05, Table 2). The overall success rate for meniscus repairs was 89% (25 of 28 menisci) at second-look arthroscopy. Conclusions: We evaluated cartilage status after meniscus repair with ACL reconstruction using second-look arthroscopy. The progression of chondral damages could not be prevented by meniscus repair with ACL reconstruction to the degree of isolated ACL reconstruction. Progression of post-traumatic chondral damages may be faster in patients who underwent ACL reconstruction and meniscus repair than in ACL-reconstructed knees with intact menisci.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT)