title: Factors associated with meniscal tears and chondral lesions in patients undergoing anterior cruciate ligament reconstruction: a prospective study.
abstract: BACKGROUND
  Increased time from anterior cruciate ligament (ACL) injury to surgery is known to be associated with increased medial meniscal tears. Few studies have examined the predictors of meniscal tears and chondral lesions, including instability episodes.
  
  
  OBJECTIVE
  To examine the predictors of meniscal tears and chondral injuries in patients undergoing ACL reconstruction.
  
  
  METHODS
  Case-control study; Level of evidence, 3.
  
  
  METHODS
  Data were collected prospectively from 541 patients undergoing ACL reconstruction. Logistic regression was used to calculate adjusted odds ratios and 95% confidence intervals for predictors of meniscal tears, tear management, and chondral injuries. Predictors included age, sex, body mass index (25-29.99 and ≥30 vs ≤24.99 kg/m(2)), mechanism (contact vs noncontact) and type (high-impact sports [basketball, football, soccer, and skiing] and other sports vs not sports related) of injury, interval from injury to surgery (≤6 vs >6 weeks and ≤12 vs >12 weeks), and instability episodes (vs none).
  
  
  RESULTS
  A total of 211 lateral meniscal tears (35.3% untreated, 48.3% meniscectomized, 16.4% repaired), 197 medial meniscal tears (25% untreated, 52% meniscectomized, 23% repaired), and 82 chondral injuries occurred. Age predicted chondral injuries. Male sex predicted more lateral meniscal tears overall, untreated lateral tears, and lateral meniscectomies as well as predicting medial meniscal tears overall and medial meniscectomies. Obesity predicted more chondral injuries. Sports-related injuries predicted fewer medial meniscal tears overall and medial meniscectomies. Injuries ≤6 weeks from surgery predicted more lateral meniscal repairs but fewer medial meniscectomies. Injuries ≤12 weeks from surgery predicted more chondral injuries. More instability episodes predicted medial meniscal tears overall, untreated medial tears, medial meniscectomies, and medial repairs.
  
  
  CONCLUSIONS
  Male sex predicted lateral meniscal tears and management. Male sex, sports, injuries ≤6 weeks from surgery, and preoperative episodes of instability predicted medial meniscal tears and management. Age predicted chondral injuries. This was one of the first studies to examine the number of instability episodes as a predictor of an intra-articular injury.
authors.affiliation: Leslie J. Bisson, University at Buffalo, The State University of New York, 4949 Harlem Road, Amherst, NY 14226. klbisson@aol.com.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kluczynski
authors.forename: John M
authors.initials: JM
authors.lastname: Marzo
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Bisson
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D001265:Athletic Injuries / Q000453:epidemiology / Q000601:surgery; D015992:Body Mass Index; D002356:Cartilage / Q000473:pathology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D050724:Fractures, Cartilage / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007718:Knee Injuries / Q000453:epidemiology / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D011446:Prospective Studies; D012421:Rupture / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D012737:Sex Factors; D000070600:Tibial Meniscus Injuries; D055815:Young Adult
keywords: ACL; chondral; knee; ligament; meniscus