title: Association between previous meniscal surgery and the incidence of chondral lesions at revision anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Knees undergoing revision anterior cruciate ligament (ACL) reconstruction typically have more intra-articular injuries than do knees undergoing primary reconstruction.
  
  
  OBJECTIVE
  Previous partial meniscectomy (PM) is associated with a higher rate of chondral lesions at revision ACL reconstruction, whereas previous meniscal repair (MR) is not associated with a higher rate of chondral lesions at revision ACL reconstruction, compared with knees undergoing revision ACL with no previous meniscal surgery.
  
  
  METHODS
  Cohort study (Prevalence); Level of evidence, 2.
  
  
  METHODS
  Data from a multicenter cohort was reviewed to determine the history of prior meniscal surgery (PM/MR) and the presence of grade II/III/IV chondral lesions at revision ACL reconstruction. The association between previous meniscal surgery and the incidence of chondral lesions was examined. Patient age was included as a covariate to determine if surgery type contributes predictive information independent of patient age.
  
  
  RESULTS
  The cohort included 725 ACL revision surgeries. Chondrosis was associated with patient age (P < .0001) and previous meniscal surgery (P < .0001). After adjusting for patient age, knees with previous PM were more likely to have chondrosis than knees with previous MR (P = .003) or no previous meniscal surgery (P < .0001). There was no difference between knees without previous meniscal surgery and knees with previous MR (P = .7). Previous partial meniscectomy was associated with a higher rate of chondrosis in the same compartment compared with knees without previous meniscal surgery (P < .0001) and knees with previous MR (P ≤ .03).
  
  
  CONCLUSIONS
  The status of articular cartilage at the time of revision ACL reconstruction relates to previous meniscal surgery independent of the effect of patient age. Previous partial meniscectomy is associated with a higher incidence of articular cartilage lesions, whereas previous meniscal repair is not. Although this association may reflect underlying differences in the knee at the time of prior surgery, it does suggest that meniscal repair is preferable when possible at the time of ACL reconstruction.
authors.affiliation: Washington University, Department of Orthopaedic Surgery, St. Louis, MO 63110, USA. brophyr@wudosis.wustl.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
authors.forename: Rick W
authors.initials: RW
authors.lastname: Wright
authors.forename: Tal S
authors.initials: TS
authors.lastname: David
authors.forename: Robert G
authors.initials: RG
authors.lastname: McCormack
authors.forename: Jon K
authors.initials: JK
authors.lastname: Sekiya
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Svoboda
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Huston
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Haas
authors.forename: Karen
authors.initials: K
authors.lastname: Steger-May
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D002648:Child; D002812:Chondroma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000473:pathology / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D011183:Postoperative Complications; D000070600:Tibial Meniscus Injuries; D014481:United States / Q000453:epidemiology; D055815:Young Adult