Summary

The rate of chondral and meniscal tears was higher in patients undergoing a second ACL revision compared to those undergoing a single ACL revision, ranging from half to 85% of cases.

Abstract

Purpose

This study aims to describe the prevalence of meniscal and chondral lesions in patients undergoing a single revision of Anterior Cruciate Ligament (ACL) versus those undergoing a second ACL revision.

Methods

A retrospective single-center study from 2012 to 2022 was conducted, involving patients who underwent at least one ACL revision. Inclusion criteria were all patients aged between 16 and 60 years which had a previous ACL reconstruction. Exclusion criteria were multi-ligament knee injuries, concomitant osteotomies and 3 or more previous ACL reconstructions.

Results

A total of 257 patients meeting inclusion and exclusion criteria with at least one revision of ACL reconstruction were identified. Of these, 204 patients were included in the single revision group (R1), and 51 patients in the multiple revisions group (R2). Two patients who underwent a third revision of ACLR were excluded. Prevalence of chondral lesions were 47.6% in revision group (R1) and 64.7% in re-revision group (R2) (p=0.045). There was a higher prevalence of medial and lateral chondral lesion in R2 group (56.9% and 39.2% respectively) compared to R1 group (36.3% and 13.5%) (p=0.012 and p=0.001). Medial meniscal tears were observed in 51% of the R1 group and 78% in the R2 group (p < 0.001). There was no difference in meniscal treatment type in the medial and lateral compartment between R1 and R2 groups.

Conclusion

The rate of chondral and meniscal tears was higher in patients undergoing a second ACL revision compared to those undergoing a single ACL revision, ranging from half to 85% of cases.