title: Association of Meniscal Status, Lower Extremity Alignment, and Body Mass Index With Chondrosis at Revision Anterior Cruciate Ligament Reconstruction.
abstract: BACKGROUND
  Knees undergoing revision anterior cruciate ligament reconstruction (rACLR) have a high prevalence of articular cartilage lesions.
  
  
  OBJECTIVE
  The prevalence of chondrosis at the time of rACLR is associated with meniscal status and lower extremity alignment.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  Data from the prospective Multicenter ACL Revision Study (MARS) cohort were reviewed to identify patients with preoperative lower extremity alignment films. Lower extremity alignment was defined by the weightbearing line (WBL) as a percentage of the tibial plateau width, while the chondral and meniscal status of each weightbearing compartment was recorded at the time of surgery. Multivariable proportional odds models were constructed and adjusted for relevant factors to examine which risk factors were independently associated with the degree of medial and lateral compartment chondrosis.
  
  
  RESULTS
  The cohort included 246 patients with lower extremity alignment films at the time of rACLR. Mean (±SD) patient age was 26.9 ± 9.5 years and body mass index (BMI) was 26.4 ± 4.6. The medial compartment had more chondrosis (grade 2/3, 42%; grade 4, 6.5%) than did the lateral compartment (grade 2/3, 26%; grade 4, 6.5%). Disruption of the meniscus was noted in 35% of patients on the medial side and 16% in the lateral side. The mean WBL was 0.43 ± 0.13. Medial compartment chondrosis was associated with BMI (P = .025), alignment (P = .002), and medial meniscal status (P = .001). None of the knees with the WBL lateral to 0.625 had grade 4 chondrosis in the medial compartment. Lateral compartment chondrosis was significantly associated with age (P = .013) and lateral meniscal status (P < .001). Subjects with "intact" menisci were found to decrease their odds of having chondrosis by 64% to 84%.
  
  
  CONCLUSIONS
  The status of articular cartilage in the tibiofemoral compartments at the time of rACLR is related to meniscal status. Lower extremity alignment and BMI are associated with medial compartment chondrosis.
authors.affiliation: Washington University, St Louis, Missouri, USA brophyr@wudosis.wustl.edu.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Brophy
authors.affiliation: Washington University, St Louis, Missouri, USA.
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Haas
authors.affiliation: Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Huston
authors.affiliation: Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: Nwosu
authors.affiliation: Washington University, St Louis, Missouri, USA.
authors.forename: Rick W
authors.initials: RW
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D015992:Body Mass Index; D002357:Cartilage Diseases / Q000601:surgery; D002358:Cartilage, Articular / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D013977:Tibia / Q000601:surgery; D055815:Young Adult
keywords: ACL reconstruction; meniscectomy; meniscus; osteoarthritis; valgus; varus