Summary

We observed retrospectively 411 patients who had undergone meniscal surgery, recorded type and locations of the meniscal tears and chondral lesions. We observed that 34.5% patients with meniscal tears had chondral injuries, this are associated with degenerative meniscal lesions and possibly with anterior horn lesions and bucket-handle tears.

Abstract

Background

Articular cartilage injuries are commonly found during meniscal arthroscopic surgery. Meniscal tear patterns are associated with the extent of chondral damage. Surgical outcomes are influenced by the type of meniscal tear and these concomitant injuries, however, association between them are currently not fully explored.

Purpose

(i) To describe the prevalence, location, and characteristics of meniscal tears; (ii) to describe articular surfaces injured and associate them with meniscal tear patterns.
Design: Retrospective cross-sectional study.

Methods

A database from 415 consecutive patients who had undergone meniscal surgery from 2017 and throughout 2019 was analyzed. Intraarticular lesions were arthroscopically observed, meniscal tear characteristics were recorded, and chondral lesions were evaluated according to the International Cartilage Repair Society (ICRS) knee form. Chi-squared independence test was used to analyze association between variables, a stepwise logistic regression was performed to explore if the observed variables are associated with the presence of chondral lesions.

Results

411 patients were analyzed with a mean age of 40 (±13) years and a masculinity of 69%. 57.2% corresponded to medial meniscus (MM), 34.8% lateral meniscus (LM) and 8% had both meniscal injuries. Close to a third (34.5%) had one or more chondral injuries furthermore, in those patients with LM injury the prevalence was lower (24.5%) (Chi2, p=0.007). In presence of MM tears, the medial femoral condyle was the most frequently affected (23.8%) followed by the patellar surface (17.9%) moreover, those surfaces had a highest ICRS classification (median: 3, IQR: 2-3). In contrast, in presence of LM tears, lateral tibial plateau (13.3%) and lateral femoral condyle (12.6%) were more affected, the ICRS classification was similar to the MM. Age, white-white zone injuries, degenerative LM lesions, anterior horn and bucket-handle type could be a risk factor for having chondral lesions.

Conclusion

Medial meniscus is more frequently lesioned and is presented with more concomitant chondral injuries. Additionally, anterior horn lesions and bucket-handle tear could be more associated with chondral injuries than other meniscal tears locations. Of all the chondral lesions, those in the medial femoral condyle and patella were more severe.