Association Between Meniscal and Chondral Lesions and Timing of Anterior Cruciate Ligament Reconstruction.

Autor:	de Campos GC; University of Campinas (UNICAMP), Campinas, Brazil., Nery W Jr; Instituto Wilson Mello, Research and Study Center, Campinas, Brazil., Teixeira PE; Instituto Wilson Mello, Research and Study Center, Campinas, Brazil., Araujo PH; Instituto Wilson Mello, Research and Study Center, Campinas, Brazil., Alves WM Jr; Instituto Wilson Mello, Research and Study Center, Campinas, Brazil.
Jazyk:	angličtina
Zdroj:	Orthopaedic journal of sports medicine [Orthop J Sports Med] 2016 Oct 21; Vol. 4 (10), pp. 2325967116669309. Date of Electronic Publication: 2016 Oct 21 (Print Publication: 2016).
DOI:	10.1177/2325967116669309
Abstrakt:	Background: Rupture of the anterior cruciate ligament (ACL) is a common sports injury and is known to be associated with an increased risk of knee osteoarthritis. Several studies have indicated that the risk of additional injuries to the menisci and articular cartilage increases with delays in the treatment of ACL tears. However, no consensus has been reached regarding the ideal timing for ACL reconstruction in terms of preventing secondary lesions. Purpose: To determine how the time elapsed between an ACL lesion and its reconstruction affects the incidence of meniscal and chondral lesions. Study Design: Case series; Level of evidence, 4. Methods: Medical records of 764 patients who underwent primary ACL reconstruction were reviewed. Data from arthroscopic findings that included information about meniscal lesions and full-thickness articular cartilage lesions at the time of surgery were collected. The association between time elapsed between ACL lesion and reconstruction surgery and incidence of articular cartilage and meniscal lesions was analyzed by chi-square or Fisher exact test. The risk of secondary lesion was calculated by odds ratios (ORs) obtained from simple logistic regression analysis. Results: A positive correlation was observed between time after injury and the presence of any articular lesions ( P = .003), cartilage lesions ( P = .01), and medial meniscus lesions ( P < .001). When analyzing the risk of secondary lesion relative to the reference period (<2 months), it was observed that the odds of finding any articular injury at the time of ACL reconstruction increased when the time from ACL injury to surgery was between 12 and 24 months (OR = 2.62) and >24 months (OR = 5.88). Furthermore, the odds of lesions on the medial meniscus increased when the timing between injury and surgery was 6 to 12 months (OR = 2.71) and continued to increase when the timing was 12 to 24 months (OR = 3.78) and >24 months (OR = 9.07). Conclusion: Associated articular lesions are more common if ACL reconstruction is delayed by ≥6 months (medial meniscus lesion) and ≥1 year (chondral or any meniscal lesion). Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.
Databáze:	MEDLINE
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