Geographic Mapping of Meniscus and Cartilage Lesions Associated with Anterior Cruciate Ligament Injuries

Slauterbeck, James R.; Kousa, Petteri; Clifton, Blake C; Naud, Shelly; Tourville, Timothy W.; Johnson, Robert J.; Beynnon, Bruce D.

doi:10.2106/jbjs.h.00888

Cited by 128 publications

(128 citation statements)

References 15 publications

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“…With each episode of giving way, meniscal tears can become more complex and less amenable to repair [8]. Studies in adult patients [7,8,24,39] and in pediatric patients [12,28,32] have shown an increased incidence of medial meniscal tears with delayed ACL reconstruction. Although the treatment of ACL tears in skeletally immature patients remains controversial [33], the risk of physeal injury and resulting growth disturbance from ACL repair to a patient with open physes is now thought to be small [15,22], and many centers (including our institution) opt for prompt reconstruction before skeletal maturity [9,16,20,25,31,34,40].…”

Section: Introductionmentioning

confidence: 99%

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Guenther

Swami

Dhillon

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Delay of as much as 5 months between ACL injury and surgery is known to be associated with increased risk of a medial meniscal tear, but the risk of additional meniscal tear progression with a longer delay to surgery is unclear. Questions/purposes We determined the (1) times of injury, MRI, and surgery in adolescents with ACL tears, and whether (2) timing of surgery, or (3) initial integrity of the meniscus seen on MR images predicted development of meniscal tears. Methods We reviewed 112 adolescents who were 15 ± 1 years old (mean ± SD) (range, 11-16 years) with a torn ACL. These patients underwent surgical repair from 2005 to 2011 in a Canadian city. We compared dates of injury, MRI, and surgery. A pediatric and musculoskeletal fellowship-trained radiologist reread the MR images, and meniscal injuries were graded according to severity. This was compared with surgical findings described in the operative report. Results Time after injury to MRI and surgery averaged 77 days (range, 1-377 days) and 342 days (range, 42-1637 days), respectively. Patients with new or worsened medial meniscal tears had waited longer for surgery (445 versus 290 days; p = 0.002). Bucket handle medial meniscal tears were more common in patients with surgery more than 1 year after injury than others (15 of 34 versus 14 of 75; p = 0.013). A medial meniscal tear observed on MR images was a significant covariate for a torn meniscus at surgery (relative risk, 5.7; 95% CI, 2.8-11.6). Medial meniscal survival continued to decline sharply greater than 1 year after injury. Conclusions Medial meniscal tears, especially bucket handle tears, increased steadily in frequency more than 1 year after ACL injury. Timely ACL reconstruction may be warranted to reduce the risk of further medial meniscal damage even in patients whose original injury occurred more than 1 year before. Level of Evidence Level IV, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.

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Section: Introductionmentioning

confidence: 99%

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Guenther

Swami

Dhillon

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…An ACL-deficient knee with a lateral meniscus lesion and a subsequent cartilage lesion on the lateral femoral condyle should be stabilised [11] and the lost meniscus tissue should be substituted. In each of the named examples cartilage repair is then nothing else than the topping on a tasty ice-cream.…”

mentioning

confidence: 99%

See the whole picture: knee preserving therapy needs more than surface repair

Arnold

Hirschmann

Verdonk

2011

Knee Surg Sports Traumatol Arthrosc

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“…As previously discussed, both meniscal injury and direct articular cartilage trauma are linked to long-term cartilage damage following a knee injury and are predictive of long term tibiofemoral and patellofemoral osteoarthritis 48 . Given that isolated rupture of the ACL is relatively rare, and the majority of ACL ruptures are accompanied by meniscal and chondral damage, the overall rate of osteoarthritis following an injury resulting in an ACL rupture is likely to be closer to the quoted 'combined injury' rate than that reported for 'isolated injuries' 19,20,34 .…”

Section: How Strong Is the Link?mentioning

confidence: 94%

“…Damage to the menisci is observed in approximately 65-75% of ACL-ruptured knees during arthroscopy 19,34 . Traumatic longitudinal tears in the posterior and middle one-third of the medial menisci account for the majority of lesions, although damage to the posterior-middle portion of the lateral meniscus is also relatively common 20 ( Figure 2).…”

Section: Meniscal Injurymentioning

confidence: 99%

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The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

Riordan

Frobell

Roemer

et al. 2013

Rheumatic Disease Clinics of North America

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Word Count: 4183 2 3 SynopsisAlthough there is an abundance of literature regarding the development of knee osteoarthritis following rupture of the anterior cruciate ligament (ACL), the exact mechanism underlying this link is still not clear.Recent studies have reported that a number of factors may be predictive of the subsequent development of osteoarthritis, with damage to the menisci and articular cartilage during the initial trauma, altered knee biomechanics post-injury, and episodic instability chief among them. This article summarizes recent developments in the understanding of the joint damage resulting from an ACL tear, and the influence that current and future treatment methods may have on the long-term progression to osteoarthritis.

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Geographic Mapping of Meniscus and Cartilage Lesions Associated with Anterior Cruciate Ligament Injuries

Abstract: Increased age, male sex, and increased surgical delay all increase the frequency and severity of injuries of the meniscus and/or articular cartilage after an anterior cruciate ligament tear.

Cited by 128 publications

References 15 publications

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

Meniscal Injury After Adolescent Anterior Cruciate Ligament Injury: How Long Are Patients at Risk?

See the whole picture: knee preserving therapy needs more than surface repair

The Health and Structural Consequences of Acute Knee Injuries Involving Rupture of the Anterior Cruciate Ligament

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