Results of Anterior Cruciate Ligament Reconstruction Based on Meniscus and Articular Cartilage Status at the Time of Surgery

TLDR

The study aimed to assess how meniscal and articular cartilage status at ACL reconstruction influences outcomes 5–15 years post‑surgery. Objective and subjective follow‑up were obtained from 482 and 928 patients, respectively, at mean 7.6 and 8.6 years after surgery. Patients with intact menisci and normal cartilage had superior objective and subjective outcomes, whereas meniscectomy and cartilage damage were associated with lower scores, indicating that meniscal and articular status at surgery significantly influence long‑term ACL reconstruction results.

Abstract

We sought to determine how the status of the meniscus and articular cartilage observed at the time of anterior cruciate ligament reconstruction affects results at 5 to 15 years after surgery. Objective follow-up was obtained on 482 patients at a mean of 7.6 years after surgery. Subjective follow-up was obtained on 928 patients at a mean of 8.6 years after surgery. Patients with both menisci present had significantly better KT-1000 arthrometer scores than did patients with any part of the medial or both menisci removed. Stepwise regression analyses determined that a partial or total medial or lateral meniscectomy and damaged articular cartilage significantly lowered the final subjective total score. Patients with both menisci present and normal articular cartilage had a mean subjective total score of 94, and 97% had normal or near normal radiographic ratings on a weightbearing 45° posteroanterior radiographs. The overall International Knee Documentation Committee rating was normal or nearly normal for 204 of 235 patients (87%) with both menisci present, 52 of 74 patients (70%) with partial or total lateral meniscectomies, 71 of 113 patients (63%) with partial or total medial meniscectomies, and 36 of 60 patients (60%) with both menisci removed. We concluded that the long-term subjective and objective results of a successful anterior cruciate ligament reconstruction are affected by the status of the menisci and articular surface.