Incidence of meniscal and osteochondral lesions in patients undergoing delayed anterior cruciate ligament reconstruction.
OBJECTIVE
Unreconstructed anterior cruciate ligament (ACL) tears cause repeated incidences of giving-way and rotational-translational instability. The aim of this study was to test our hypothesis that delayed surgical treatment of patients with ACL tears, especially those with high Tegner activity levels, results in more severe and complicated meniscal and osteochondral lesions with potential affect on the outcome.


METHODS
This study included 385 patients who underwent arthroscopic ACL reconstruction between 2001 and 2009. Patients arthroscopic video records or MRI scans and patient files at the time of surgery were analyzed. We defined severe meniscal and osteochondral lesions which could negatively affect the outcome and labeled them meniscal lesions affecting outcome (MLAO) and osteochondral lesions affecting outcome (OLAO). The relation between MLAO, OLAO, time since injury and Tegner activity levels were statistically analyzed.


RESULTS
The incidences of MLAO and OLAO grew statistically higher as time elapsed between the injury and surgery increased (p=0.001, p<0.05; p=0.001, p<0.05). The relation between the Tegner activity score, MLAO and OLAO risk were found to be statistically insignificant (p=0.317, p=0.184, p>0.05).


CONCLUSIONS
Delays in ACL reconstruction surgery result in an increase in the incidence of meniscal and osteochondral lesions which have the potential to negatively affect the surgical outcome.
Department of Orthopaedics and Traumatology, Faculty of Medicine, Uludağ University, Bursa, Turkey. burakdemirag@hotmail.com
Burak
B
Demirağ
Fatih
F
Aydemir
Mutlu
M
Daniş
Cenk
C
Ermutlu
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects* / Q000379:methods; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology; D008875:Middle Aged; D010007:Osteochondritis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult