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Factors Associated with Articular Cartilage Injuries in Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Multicentre Study


Atsuo Nakamae, MD, PhD
JAPAN

Factors Associated with Articular Cartilage Injuries in Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Multicentre Study

Atsuo Nakamae, MD, PhD, JAPAN Kazuhiro Tsukisaka, MD, , JAPAN Masataka Deie, MD, PhD, Prof., JAPAN Masakazu Ishikawa, MD, PhD, JAPAN Goki Kamei, MD, PhD, JAPAN Nobuo Adachi, MD, PhD, JAPAN

Hiroshima University, Hiroshima, JAPAN

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Ligaments Cartilage

Diagnosis / Condition

Instability

Treatment / Technique

Repair / Reconstruction Arthroscopy Autograft Double Bundle Single Bundle

Ligaments

ACL

Patient Populations

Pediatric / Adolescent

Cartilage

Cartilage Injuries

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Summary: An older age, a longer duration between injury and surgery, and positive pivot shift test results increase the prevalence of articular cartilage injury during ACL reconstruction in all three compartments of the knee in patients with ACL injuries

Purpose

To investigate factors that influence the prevalence of articular cartilage injury in patients with anterior cruciate ligament (ACL) injury.

Methods

This multicentre study included patients with ACL injury. Logistic regression analysis was conducted to identify factors that influence the prevalence of cartilage injury during ACL reconstruction. Cartilage characteristics were evaluated via arthroscopy.

Results

A total of 811 patients were enrolled. The factors that significantly influenced the prevalence of cartilage injury were age (odds ratio [OR], 1.04; P = 0.000), a positive pivot shift test result (OR, 1.43; P = 0.021), medial meniscal injury (OR, 2.55; P = 0.000), and delayed surgery (=12 months) (OR, 2.52; P = 0.028) in the medial compartment of the knee; age (OR, 1.05; P = 0.000), subjective grades of apprehension during the pivot shift test (OR, 1.46; P = 0.010), lateral meniscal injury (OR, 1.98; P = 0.003), femoro-tibial angle (FTA) (OR, 0.92; P = 0.006), and delayed surgery (=12 months) (OR, 2.63; P = 0.001) in the lateral compartment; and age (OR, 1.06; P = 0.000), body mass index (OR, 1.07; P = 0.028), a positive pivot shift test result (OR, 1.60; P = 0.018), FTA (OR, 0.90; P = 0.006), and delayed surgery (=12 months) (OR, 3.17; P = 0.008) in the patellofemoral compartment.

Conclusion

An older age, a longer duration between injury and surgery, and a positive pivot shift test result increase the prevalence of articular cartilage injury at the time of ACL reconstruction in all three compartments of the knee in patients with ACL injuries. An elevated BMI is significantly associated with the prevalence of cartilage injury in the PF compartment. A smaller FTA is significantly associated with the prevalence of cartilage injury in the lateral and PF compartments. Medial and lateral meniscal injuries are significantly associated with the prevalence of cartilage injuries in the medial and lateral knee compartments, respectively. The clinical relevance of this study is that early ACL reconstruction is recommended, especially for patients who have positive pivot shift test results, to prevent additional damage to the articular cartilage.

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