title: Variables Associated with Chondral and Meniscal Injuries in Anterior Cruciate Ligament Surgery.
abstract: This article aims to evaluate factors associated with chondral and meniscal lesions in primary and revision anterior cruciate ligament (ACL) reconstructions. ACL reconstructions from 2001 to 2008 at a single institution were retrospectively analyzed. Logistic regression was used to estimate the association between chondral and meniscal injuries and age, gender, tear chronicity, additional ligamentous injuries, sport type, and participation level. Of the 3,040 ACL reconstructions analyzed, 90.4% were primary reconstructions and 9.6% were revisions. Meniscal injuries were significantly lower in the revision group (44.0 vs. 51.9%;p= 0.01), while chondral injuries were significantly higher in the revision group (39.9 vs. 24.0%;p< 0.0001). Inspection of the small subgroup (n= 85) receiving both primary and revision ACL surgery at our center indicated that meniscal injuries at revision were evenly split between menisci with and without previous repairs, whereas the vast majority of Grade III and IV chondral lesions were new. More patients presented for surgery later in the revision group than in the primary group (56.5 vs. 35.3%;p< 0.0001). Male gender, primary reconstruction, and short interval (less than 2 weeks) between injury and surgery were associated with increased likelihood of meniscus tear. Age (greater than 22 years) and long interval (greater than 6 weeks) between injury to surgery and higher sport activity level were associated with chondral lesions. Revision ACL reconstructions are associated with a higher proportion of chondral lesions and a lower proportion of meniscal tears. Early primary and revision ACL construction is recommended to reduce the probability of chondral lesions.
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.
authors.forename: E Lyle
authors.initials: EL
authors.lastname: Cain
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.
authors.forename: Glenn S
authors.initials: GS
authors.lastname: Fleisig
authors.affiliation: Department of Orthopedic Surgery, UAB, Birmingham, Alabama.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Ponce
authors.affiliation: Department of Orthopedic Surgery, UAB, Birmingham, Alabama.
authors.forename: Hikel A
authors.initials: HA
authors.lastname: Boohaker
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.|Department of Orthopedic Surgery, UAB, Birmingham, Alabama.
authors.forename: Martha P
authors.initials: MP
authors.lastname: George
authors.affiliation: Department of Research/Epidemiology, UAB, Birmingham, Alabama.
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.
authors.forename: James R
authors.initials: JR
authors.lastname: Andrews
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Lemak
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.
authors.forename: William G
authors.initials: WG
authors.lastname: Clancy
authors.affiliation: American Sports Medicine Institute, Birmingham, Alabama.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Dugas
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D002357:Cartilage Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery; D000070600:Tibial Meniscus Injuries / Q000601:surgery*; D055815:Young Adult