title: Articular cartilage status 2 years after arthroscopic ACL reconstruction in patients with or without concomitant meniscal surgery: evaluation with 3.0T MR imaging.
abstract: OBJECTIVE
  To assess articular cartilage changes in the knee joint as detected on 3.0T MR imaging after 2-year follow-up in patients who underwent arthroscopic anterior cruciate ligament reconstruction (ACLR) with or without concomitant meniscal surgery.
  
  
  METHODS
  A total of twenty-nine patients (mean age 30.3 ± 10 years), who underwent arthroscopic ACLR, received clinical and imaging follow-up at an average of 27.8 ± 4.8 months after surgery. Our patients were divided into two subgroups: eighteen patients with additional meniscal injuries at the time of arthroscopic ACLR who underwent meniscal surgery and eleven patients with intact menisci. The cartilage status of all knees at the time of arthroscopic ACLR was recorded. All patients underwent an MRI scan preoperatively and at follow-up with the same imaging protocol. Cartilage status of all knee compartments was evaluated at the time of follow-up by MR imaging and the ICRS classification.
  
  
  RESULTS
  Deterioration of the cartilage status was found at all knee compartments of our study group, with respect to the number of cartilage defects. The cartilage of the lateral femoral condyle (LFC) was most severely affected, followed by patellar and medial femoral condyle (MFC) cartilage. A statistically significant relation was found between surgery of the medial meniscus and the development of new cartilage defects in LFC (p = 0.01) and MFC (p = 0.03) after adjusting for the site of meniscal surgery. The cartilage of LFC and the status of the medial meniscus were also found to be significantly related (p = 0.04). Partial meniscectomy was found to be associated with an increased incidence of new cartilage defects when compared to either meniscal repair or absence of meniscal surgery, although it was not statistically significant.
  
  
  CONCLUSIONS
  Development of new cartilage lesions was evident after 2-year follow-up in patients with arthroscopic ACLR as detected by MR imaging. There was a multicompartmental pattern of cartilage involvement, and the lateral compartment was most severely affected. Partial meniscectomy at the time of arthroscopic ACLR could be suggested as an additional risk factor for the progression of chondral lesions.
  
  
  METHODS
  Prospective comparative study, Level II.
authors.affiliation: Department of Orthopedics, University Hospital of Larissa, Larissa, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Michalitsis
authors.affiliation: Department of Orthopedics, University Hospital of Larissa, Larissa, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Hantes
authors.affiliation: Department of Radiology, University Hospital of Larissa, Biopolis, 41110, Larissa, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Thriskos
authors.affiliation: Laboratory of Molecular Genetics, University Hospital of Larissa, Larissa, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Tsezou
authors.affiliation: Department of Orthopedics, University Hospital of Larissa, Larissa, Greece.
authors.forename: K N
authors.initials: KN
authors.lastname: Malizos
authors.affiliation: Department of Radiology, University Hospital of Larissa, Biopolis, 41110, Larissa, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Fezoulidis
authors.affiliation: Department of Radiology, University Hospital of Larissa, Biopolis, 41110, Larissa, Greece. mvlychou@med.uth.gr.
authors.forename: M
authors.initials: M
authors.lastname: Vlychou
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000601:surgery*; D004838:Epiphyses / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D055815:Young Adult
keywords: 3.0T MRI; Anterior cruciate ligament reconstruction; Cartilage