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Delaying ACL Reconstruction Increases the Risk of Medial Meniscal Tear

Delaying ACL Reconstruction Increases the Risk of Medial Meniscal Tear

Julien Erard, MD, FRANCE Nicolas Cance, Resident, FRANCE Jobe Shatrov, MD, AUSTRALIA Gaspard Fournier, MD, FRANCE Stanislas Gunst, MD, FRANCE Gianluca Ciolli, MD, ITALY Pasquale Porcelli, MD, ITALY Sebastien Lustig, MD, PhD, FRANCE Elvire Servien, MD, PhD, Prof., FRANCE

Croix-Rousse Hospital, LYON, Rhone, FRANCE


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Diagnosis / Condition

Anatomic Location

Anatomic Structure

Diagnosis Method

MRI

Ligaments

ACL


Summary: Delaying ACLR for more than 12 months significantly increased the rate of medial meniscal injury.


Purpose

Optimal timing between anterior cruciate ligament (ACL) injury and reconstruction (ACLR) remains debated. The aim of this study was to evaluate the relationship between the time from injury to ACLR and the rate as well as repairability of meniscal tears. Secondary aims of the study were to evaluate the relationship between meniscal injury and Tegner activity Scale (TAS), age, BMI, and gender.

Materials And Methods

Between 2012 to 2022, 1840 ACLR were performed. 1317 ACLR were included, with a mean age of 31.2 ±10.5 [16-60], a mean BMI of 24.3 ±3.7 [16.0-40.2]. The mean pre-operative TAS was 6.2±1.4 [1-10]. Meniscal tear was assessed during arthroscopy using ISAKOS classification. Rate of meniscus repair was also assessed. Delay to ACLR, TAS, age, BMI and gender were analyzed in uni- then multivariate analyses. Patients were divided in 4 groups according to the delay of the surgery: <3 months (427; 32%), 3 to 6 months (388; 29%), 6 to 12 months (248; 19%) and > 12 months (254; 19%).

Results

Delaying ACLR of more than 12 months significantly increased the rate of medial meniscal injury (OR 1.14; p=0.000). No correlation was found between a 3- or 6-month delay and medial meniscal tear. Delaying ACLR by more than 3, 6, or 12-month did not significantly increase the rate of lateral meniscal tear. No correlation was found between delaying ACLR by more than 3, 6, or 12-month and the rate of repairability of meniscal injury. Increasing TAS was significantly associated with a lower rate of medial meniscal injury (OR 0.90; p=0.020). An age>30 (OR 1.07; p=0.025) and male gender (OR 1.13; p<0.0001) were also associated with an increased rate of medial meniscal injury. An age>30 decreased the rate of medial meniscal suture (OR 0.85; p=0.000). Male gender increased the rate of meniscal tear (OR 1.10; p=0.001).

Conclusion.
Delaying ACLR beyond 12 months significantly increased the rate of medial meniscal tear without effecting the repairability of the tear. Increasing pre-injury TAS was associated with a decreased rate of medial meniscal tear. Age>30 increased the rate of medial meniscal tear and decreased the rate of repairability of medial meniscal tear.


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