Untreated Asymptomatic Deep Cartilage Lesions Associated with Anterior Cruciate Ligament Injury

Abstract

Background Chondral lesions are often documented at the time of anterior cruciate ligament reconstruction. They are usually asymptomatic. It is not known if these lesions change the outcome of current ACL treatments. Hypothesis Untreated deep cartilage lesions incidentally found during anterior cruciate ligament reconstruction do not affect clinical and radiological results. Study Design Case control study; Level of evidence, 3. Methods From 1991 to 1995, 586 anterior cruciate ligament reconstructions were performed; 51 of these were in patients with a concomitant single focal chondral lesion of Outerbridge grade 3 or 4. The mean defect size was 2.1 cm2 (range, 0.5-4.0 cm2). The control group (anterior cruciate ligament injury only) was matched for sex, age, and operation time. Outcomes were reported at 10- and 15-year follow-up using International Knee Documentation Committee criteria, Lysholm score, and Tegner activity scale. Results Forty-two patients were evaluated at 10-year follow-up and 36 at 15-year follow-up. At 10-year follow-up according to Lysholm, Tegner, and International Knee Documentation Committee objective scores, no statistical differences were noted between the groups. The mean total International Knee Documentation Committee subjective score was significantly lower in the defect group than in the control group (mean, 79.6 points vs 83.7; P = .031). At 15 years, there were no statistical differences according to Lysholm, Tegner, and either objective or subjective International Knee Documentation Committee scores. Conclusion Deep cartilage lesions found during anterior cruciate ligament reconstruction, left with no treatment, do not appear to affect clinical outcome at 10- and 15-year follow-up.