title: Patients with focal full-thickness cartilage lesions benefit less from ACL reconstruction at 2-5 years follow-up.
abstract: OBJECTIVE
  To investigate differences in patient-reported outcome after anterior cruciate ligament (ACL) reconstruction between patients with and without a concomitant full-thickness cartilage lesion.
  
  
  METHODS
  30 primary ACL-reconstructed patients with an isolated concomitant full-thickness cartilage lesion and 59 matched controls without cartilage lesions were identified in the Norwegian National Knee Ligament Registry and included in the present study. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as the outcome measure. At a median follow-up of 2.1 years (range, 2-5 years) after ACL reconstruction, 80 (90%) of the patients completed the KOOS.
  
  
  RESULTS
  Preoperatively, there were no differences in KOOS between the study group and the control group. At follow-up, patients with full-thickness cartilage lesions reported significantly decreased scores compared to patients without cartilage lesions in the KOOS subscales pain (mean difference, 8.1; 95% confidence interval [CI], 0.8-15.3), activities in daily living (mean difference, 5.8; 95% CI, 0.3-11.2), sport/recreation (mean difference, 19.8; 95% CI, 5.3-34.3) and quality of life (mean difference, 17.2; 95% CI, 4.2-30.1). Patients with full-thickness cartilage lesions reported significantly less improvement from preoperative to follow-up than patients without cartilage lesions for the KOOS subscales pain (mean difference, 11.6; 95% CI, 3.2-19.9), sport/recreation (mean difference, 20.6; 95% CI, 8.1-33.1) and quality of life (mean difference, 16.3; 95% CI, 3.8-28.7).
  
  
  CONCLUSIONS
  ACL-injured patients with full-thickness cartilage lesions reported worse outcomes and less improvement after ACL reconstruction than those without cartilage lesions at 2-5 years follow-up.
  
  
  METHODS
  Prognostic; prospective cohort study, Level I.
authors: Department of Orthopedic Surgery, and Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, 1478, Lørenskog, Norway. janhrot@medisin.uio.no
authors: Jan Harald
authors: JH
authors: Røtterud
authors: May Arna
authors: MA
authors: Risberg
authors: Lars
authors: L
authors: Engebretsen
authors: Asbjørn
authors: A
authors: Årøen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000150:complications / Q000601:surgery*; D008297:Male; D020370:Osteoarthritis, Knee / Q000150:complications / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011788:Quality of Life