J Knee Surg 2019; 32(11): 1128-1132
DOI: 10.1055/s-0038-1675783
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Correlation of Meniscal Tear with Timing of Anterior Cruciate Ligament Reconstruction in Patients without Initially Concurrent Meniscal Tear

Kun-Hui Chen
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
3   Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
,
En-Rung Chiang
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
,
Hsin-Yi Wang
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
4   Department of Anaesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
5   Institute of Translational and Interdisciplinary Medicine & Department of Biomedical Sciences and Engineering, National Central University, Chungli, Taiwan
,
Hsiao-Li Ma
1   Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
› Author Affiliations
Further Information

Publication History

07 June 2018

08 October 2018

Publication Date:
16 November 2018 (online)

Abstract

The incidence of meniscal tear was reported to increase with the delay of anterior cruciate ligament reconstruction (ACLR). The tear may occur concurrently with the ACL injury or after the ACL injury. Few studies had focused on the patients whose meniscus is intact during ACL injury. We determined the correlation between timing of surgery and incidence of meniscal tears in ACL-deficient knees with initially intact meniscus. We retrospectively reviewed 387 patients who had undergone primary ACLR. Time of initial ACL injury, magnetic resonance imaging (MRI) examination, and surgery was recorded. The MRI was reviewed by experienced radiologic and orthopaedic doctors. Intraoperative arthroscopic images were also obtained and reviewed. The type of tear noted during surgery was classified according to the modification of International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine classification of meniscal tears. Patients were divided into early (surgery within 12 months from injury) and late surgery group (surgery at more than 12 months from injury). There were 216 patients with intact medial meniscus and 257 patients with intact lateral meniscus on the postinjury MRI study. The incidence of medial meniscus tear (MMT) was significantly higher than lateral meniscus tear (LMT) during the ACLR (33.8 vs. 19.8%, p < 0.001). The incidence of MMT is higher in late group than in early group (53.7 vs. 29.1%, p = 0.004, odds ratio= 2.815). The incidence of LMT is mildly higher in late group but without statistics significance (23.8 vs. 18.6%, p = 0.364). In both MMT and LMT, the most common injury pattern observed was a longitudinal tear. The incidence of each type is not different between early and late group. For patients without concurrent meniscal injuries with the ACL tear, the incidence of MMT significantly increased if ACLR was performed more than 12 months after injury. The medial meniscus was more prone to injury than the lateral meniscus in chronic ACL-deficient knee. ACLR should be performed earlier to reduce the risk of meniscal tears for patients without initially concurrent meniscal tear.

 
  • References

  • 1 Andernord D, Karlsson J, Musahl V, Bhandari M, Fu FH, Samuelsson K. Timing of surgery of the anterior cruciate ligament. Arthroscopy 2013; 29 (11) 1863-1871
  • 2 Harner CD, Irrgang JJ, Paul J, Dearwater S, Fu FH. Loss of motion after anterior cruciate ligament reconstruction. Am J Sports Med 1992; 20 (05) 499-506
  • 3 Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 2007; 35 (10) 1756-1769
  • 4 Øiestad BE, Engebretsen L, Storheim K, Risberg MA. Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 2009; 37 (07) 1434-1443
  • 5 Magnussen RA, Mansour AA, Carey JL, Spindler KP. Meniscus status at anterior cruciate ligament reconstruction associated with radiographic signs of osteoarthritis at 5- to 10-year follow-up: a systematic review. J Knee Surg 2009; 22 (04) 347-357
  • 6 van Meer BL, Meuffels DE, van Eijsden WA, Verhaar JA, Bierma-Zeinstra SM, Reijman M. Which determinants predict tibiofemoral and patellofemoral osteoarthritis after anterior cruciate ligament injury? A systematic review. Br J Sports Med 2015; 49 (15) 975-983
  • 7 Church S, Keating JF. Reconstruction of the anterior cruciate ligament: timing of surgery and the incidence of meniscal tears and degenerative change. J Bone Joint Surg Br 2005; 87 (12) 1639-1642
  • 8 Guenther ZD, Swami V, Dhillon SS, Jaremko JL. Meniscal injury after adolescent anterior cruciate ligament injury: how long are patients at risk?. Clin Orthop Relat Res 2014; 472 (03) 990-997
  • 9 Chhadia AM, Inacio MC, Maletis GB, Csintalan RP, Davis BR, Funahashi TT. Are meniscus and cartilage injuries related to time to anterior cruciate ligament reconstruction?. Am J Sports Med 2011; 39 (09) 1894-1899
  • 10 Granan LP, Bahr R, Lie SA, Engebretsen L. Timing of anterior cruciate ligament reconstructive surgery and risk of cartilage lesions and meniscal tears: a cohort study based on the Norwegian National Knee Ligament Registry. Am J Sports Med 2009; 37 (05) 955-961
  • 11 Hagino T, Ochiai S, Senga S. , et al. Meniscal tears associated with anterior cruciate ligament injury. Arch Orthop Trauma Surg 2015; 135 (12) 1701-1706
  • 12 Ghodadra N, Mall NA, Karas V. , et al. Articular and meniscal pathology associated with primary anterior cruciate ligament reconstruction. J Knee Surg 2013; 26 (03) 185-193
  • 13 Brambilla L, Pulici L, Carimati G. , et al. Prevalence of associated lesions in anterior cruciate ligament reconstruction: correlation with surgical timing and with patient age, sex, and body mass index. Am J Sports Med 2015; 43 (12) 2966-2973
  • 14 de Campos GC, Nery Jr W, Teixeira PE, Araujo PH, Alves Jr WM. Association between meniscal and chondral lesions and timing of anterior cruciate ligament reconstruction. Orthop J Sports Med 2016; 4 (10) 2325967116669309
  • 15 Dumont GD, Hogue GD, Padalecki JR, Okoro N, Wilson PL. Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med 2012; 40 (09) 2128-2133
  • 16 Lawrence JT, Argawal N, Ganley TJ. Degeneration of the knee joint in skeletally immature patients with a diagnosis of an anterior cruciate ligament tear: is there harm in delay of treatment?. Am J Sports Med 2011; 39 (12) 2582-2587
  • 17 Anderson AF, Anderson CN. Correlation of meniscal and articular cartilage injuries in children and adolescents with timing of anterior cruciate ligament reconstruction. Am J Sports Med 2015; 43 (02) 275-281
  • 18 Yoo JC, Ahn JH, Lee SH, Yoon YC. Increasing incidence of medial meniscal tears in nonoperatively treated anterior cruciate ligament insufficiency patients documented by serial magnetic resonance imaging studies. Am J Sports Med 2009; 37 (08) 1478-1483
  • 19 Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL. Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J Orthop Res 2000; 18 (01) 109-115
  • 20 Arner JW, Irvine JN, Zheng L. , et al. The effects of anterior cruciate ligament deficiency on the meniscus and articular cartilage: a novel dynamic in vitro pilot study. Orthop J Sports Med 2016; 4 (04) 2325967116639895
  • 21 Ichiba A, Kishimoto I. Effects of articular cartilage and meniscus injuries at the time of surgery on osteoarthritic changes after anterior cruciate ligament reconstruction in patients under 40 years old. Arch Orthop Trauma Surg 2009; 129 (03) 409-415
  • 22 Lidén M, Sernert N, Rostgård-Christensen L, Kartus C, Ejerhed L. Osteoarthritic changes after anterior cruciate ligament reconstruction using bone-patellar tendon-bone or hamstring tendon autografts: a retrospective, 7-year radiographic and clinical follow-up study. Arthroscopy 2008; 24 (08) 899-908
  • 23 Lorbach O, Kieb M, Herbort M, Weyers I, Raschke M, Engelhardt M. The influence of the medial meniscus in different conditions on anterior tibial translation in the anterior cruciate deficient knee. Int Orthop 2015; 39 (04) 681-687
  • 24 Ahn JH, Bae TS, Kang KS, Kang SY, Lee SH. Longitudinal tear of the medial meniscus posterior horn in the anterior cruciate ligament-deficient knee significantly influences anterior stability. Am J Sports Med 2011; 39 (10) 2187-2193
  • 25 Melton JT, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP. Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 2011; 19 (10) 1729-1734
  • 26 Noyes FR, Barber-Westin SD. Treatment of meniscus tears during anterior cruciate ligament reconstruction. Arthroscopy 2012; 28 (01) 123-130
  • 27 Shelbourne KD, Dersam MD. Comparison of partial meniscectomy versus meniscus repair for bucket-handle lateral meniscus tears in anterior cruciate ligament reconstructed knees. Arthroscopy 2004; 20 (06) 581-585
  • 28 Barenius B, Ponzer S, Shalabi A, Bujak R, Norlén L, Eriksson K. Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. Am J Sports Med 2014; 42 (05) 1049-1057
  • 29 Tenuta JJ, Arciero RA. Arthroscopic evaluation of meniscal repairs. Factors that effect healing. Am J Sports Med 1994; 22 (06) 797-802
  • 30 Sharifah MI, Lee CL, Suraya A, Johan A, Syed AF, Tan SP. Accuracy of MRI in the diagnosis of meniscal tears in patients with chronic ACL tears. Knee Surg Sports Traumatol Arthrosc 2015; 23 (03) 826-830
  • 31 Wong KP, Han AX, Wong JL, Lee DY. Reliability of magnetic resonance imaging in evaluating meniscal and cartilage injuries in anterior cruciate ligament-deficient knees. Knee Surg Sports Traumatol Arthrosc 2017; 25 (02) 411-417
  • 32 Laundre BJ, Collins MS, Bond JR, Dahm DL, Stuart MJ, Mandrekar JN. MRI accuracy for tears of the posterior horn of the lateral meniscus in patients with acute anterior cruciate ligament injury and the clinical relevance of missed tears. AJR Am J Roentgenol 2009; 193 (02) 515-523
  • 33 Yaqoob J, Alam MS, Khalid N. Diagnostic accuracy of magnetic resonance imaging in assessment of meniscal and ACL tear: correlation with arthroscopy. Pak J Med Sci 2015; 31 (02) 263-268