Early chondral damage following meniscus repairs with anterior cruciate ligament reconstruction.

Anterior cruciate ligament reconstruction Chondral damage Meniscal repair

Journal

Asia-Pacific journal of sports medicine, arthroscopy, rehabilitation and technology
ISSN: 2214-6873
Titre abrégé: Asia Pac J Sports Med Arthrosc Rehabil Technol
Pays: Singapore
ID NLM: 101648546

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 30 10 2019
revised: 10 01 2020
accepted: 16 01 2020
entrez: 12 2 2020
pubmed: 12 2 2020
medline: 12 2 2020
Statut: epublish

Résumé

Meniscal tears are commonly observed in patients with anterior cruciate ligament (ACL) injuries. Meniscal repair has become a common procedure for the injured meniscus, and good clinical outcomes have been reported in such cases when used concurrently with ACL reconstruction. However, it is unclear whether early chondral damage progression can be prevented following meniscal repair with ACL reconstruction, as meniscal damage is a potential risk factor for the development of osteoarthritis. The purpose of this study was to evaluate the zone-specific chondral damage that occurs after arthroscopic meniscal repair with concomitant ACL reconstruction. Our hypothesis was that meniscal repair with ACL reconstruction would not decrease the rate of progression of chondral damage compared to that observed in isolated ACL reconstruction with intact menisci. This study included 40 patients who underwent anatomic double-bundle ACL reconstruction. We divided the patients into the following two groups: Group A with an intact meniscus (20 knees) and Group M requiring meniscal repair (20 knees). Chondral damage was evaluated arthroscopically in six compartments and 40 sub-compartments, and these features were graded using the International Cartilage Repair Society lesion classification. The cartilage damage in each sub-compartment and compartment was compared between the two groups both at reconstruction and at second-look arthroscopy (average 16 months postoperatively). At the latest follow-up examination (average 37 months postoperatively), the International Knee Documentation Committee (IKDC) score was compared between the two groups. Group M had a significantly worse cartilage status than Group A in five sub-compartments (mainly in the medial compartment) at reconstruction and in nine sub-compartments (mainly in the bilateral compartments) at second-look arthroscopy. The mean IKDC score was better in Group A than in Group M (Group A; 90 vs. Group M; 86). The overall success rate of meniscal repairs was 92% (23 of 25 menisci) at second-look arthroscopy. The progression of post-traumatic chondral damage may occur at a faster rate in patients who require ACL reconstruction and meniscal repair than in patients with intact menisci.

Sections du résumé

BACKGROUND BACKGROUND
Meniscal tears are commonly observed in patients with anterior cruciate ligament (ACL) injuries. Meniscal repair has become a common procedure for the injured meniscus, and good clinical outcomes have been reported in such cases when used concurrently with ACL reconstruction. However, it is unclear whether early chondral damage progression can be prevented following meniscal repair with ACL reconstruction, as meniscal damage is a potential risk factor for the development of osteoarthritis. The purpose of this study was to evaluate the zone-specific chondral damage that occurs after arthroscopic meniscal repair with concomitant ACL reconstruction. Our hypothesis was that meniscal repair with ACL reconstruction would not decrease the rate of progression of chondral damage compared to that observed in isolated ACL reconstruction with intact menisci.
METHODS METHODS
This study included 40 patients who underwent anatomic double-bundle ACL reconstruction. We divided the patients into the following two groups: Group A with an intact meniscus (20 knees) and Group M requiring meniscal repair (20 knees). Chondral damage was evaluated arthroscopically in six compartments and 40 sub-compartments, and these features were graded using the International Cartilage Repair Society lesion classification. The cartilage damage in each sub-compartment and compartment was compared between the two groups both at reconstruction and at second-look arthroscopy (average 16 months postoperatively). At the latest follow-up examination (average 37 months postoperatively), the International Knee Documentation Committee (IKDC) score was compared between the two groups.
RESULTS RESULTS
Group M had a significantly worse cartilage status than Group A in five sub-compartments (mainly in the medial compartment) at reconstruction and in nine sub-compartments (mainly in the bilateral compartments) at second-look arthroscopy. The mean IKDC score was better in Group A than in Group M (Group A; 90 vs. Group M; 86). The overall success rate of meniscal repairs was 92% (23 of 25 menisci) at second-look arthroscopy.
CONCLUSION CONCLUSIONS
The progression of post-traumatic chondral damage may occur at a faster rate in patients who require ACL reconstruction and meniscal repair than in patients with intact menisci.

Identifiants

DOI: 10.1016/j.asmart.2020.01.001 PMID: 32042596 PMC: PMC6997621
pubmed: 32042596
doi: 10.1016/j.asmart.2020.01.001
pii: S2214-6873(19)30074-3
pmc: PMC6997621
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1-5

Informations de copyright

© 2020 Asia Pacific Knee, Arthroscopy and Sports Medicine Society. Published by Elsevier (Singapore) Pte Ltd.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest relevant to this article.

Références

Am J Sports Med. 2014 Sep;42(9):2184-92
pubmed: 25023440
Arthritis Rheum. 2009 Mar;60(3):831-9
pubmed: 19248082
Am J Sports Med. 2015 Jul;43(7):1583-90
pubmed: 25899429
Arthroscopy. 2010 Oct;26(10):1302-10
pubmed: 20887929
J Rheumatol. 2007 Apr;34(4):776-84
pubmed: 17361984
Am J Sports Med. 2019 Oct;47(12):2888-2894
pubmed: 31469576
Knee Surg Relat Res. 2018 Dec 1;30(4):348-355
pubmed: 30466255
Am J Sports Med. 2019 Jun;47(7):1583-1590
pubmed: 31145668
Knee. 2003 Mar;10(1):1-11
pubmed: 12649021
Knee Surg Sports Traumatol Arthrosc. 2011 Oct;19(10):1729-34
pubmed: 21479642
Am J Sports Med. 2010 Jun;38(6):1094-102
pubmed: 20305053
J Orthop Surg Res. 2015 Mar 18;10:34
pubmed: 25889148
Am J Sports Med. 2014 Nov;42(11):2715-21
pubmed: 25227945
Am J Sports Med. 2009 Jun;37(6):1111-5
pubmed: 19465734
Orthop Traumatol Surg Res. 2015 May;101(3):391-3
pubmed: 25748135
J Orthop Sci. 2019 Nov;24(6):1058-1063
pubmed: 31444009
Am J Sports Med. 1986 Jul-Aug;14(4):270-5
pubmed: 3755296
Am J Sports Med. 2001 Mar-Apr;29(2):226-31
pubmed: 11292050
Orthop Traumatol Surg Res. 2009 Oct;95(6):437-42
pubmed: 19747891
Arthroscopy. 2008 Aug;24(8):899-908
pubmed: 18657738
Am J Sports Med. 2010 Aug;38(8):1533-41
pubmed: 20566719
Arthroscopy. 2000 Nov;16(8):822-9
pubmed: 11078538

Auteurs

Takaaki Hiranaka (T)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Takayuki Furumatsu (T)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Yusuke Kamatsuki (Y)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Kazuhisa Sugiu (K)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Shinichi Miyazawa (S)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Yoshiki Okazaki (Y)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Shin Masuda (S)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Yuki Okazaki (Y)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Yuya Kodama (Y)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Toshifumi Ozaki (T)

Department of Orthopaedic Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Classifications MeSH