Injury patterns in patients presenting with a recurrent anterior cruciate ligament tear following primary reconstruction

Abstract

Background: An anterior cruciate ligament (ACL) graft rupture or a primary ACL injury in the contralateral knee is one of the greatest concerns of patients following primary anterior cruciate ligament reconstruction (ACLR). Our study describes the epidemiology and presence of concomitant meniscal injuries of patients with a graft rupture following primary ACLR or a primary rupture of the contralateral ACL following primary ACLR of the ipsilateral knee. Methods:We reviewed the medical records of 42 patients who underwent a second ACLR. ACLR was performed using the ipsilateral semitendinosus and gracilis autograft. Variables extracted included the presence of concomitant MM and LM injuries intra-operatively, the patients' level of intensity of sport (light, moderate, strenuous), duration of rehabilitation and mechanism of injury (contact, non-contact).Results: Twenty-four (57.1%) patients had graft rupture of a previously reconstructed ACL of which 20 (83.3%) were male and 18 (42.9%) patients had a primary ACL tear of the contralateral knee following ACLR of the ipsilateral knee of which 18 (100%) were male. Patient who sustained a graft rupture were younger (29.5 vs.31.9 years), had a higher body mass index (BMI) (26.42 vs. 25.10 kg/m 2 ) and had a longer time before re-injury (6.18 vs. 4.94 years). Concomitant meniscal injury rates were comparable in both groups and the medial meniscus was injured more often.Conclusions: This study describes the demographics of 2 nd ACL injuries in the Asian population. Additional studies that investigate the differences in knee anatomy of Asians and Caucasians and their impact on ACL injuries should be performed.

Does Surgery for Concomitant Cruciate and Meniscus Injuries Increase or Decrease Subsequent Comorbidities at 2 Years?

“…Although the specific mechanisms of injuries vary, most concurrent cruciate and meniscus injuries involve cutting and pivoting movements or landing from a jump with the knee near full extension, during active sports or military training. 1 Injuries to both the menisci and cruciate ligaments are generally acute and may lead to chronic instability, 2 3 osteoarthritis (OA), 4 and/or subsequent collateral ligament injury, 5 and/or physical activity change. 6 Worse 2-to-10-year-old patient-reported outcomes have been reported for individuals with combined anterior cruciate ligament (ACL) and meniscal injuries.…”

Epidemiology of recurrent anterior cruciate ligament injuries according to sport type

“…Some hypothesized but unproven risk factors include notch width, knee alignment, deconditioning of the contralateral knee, and hereditary predisposition. 6 Recurrent ACL injuries as per literature is defined as injury occurring in the same knee that has been previously treated for ACL. The purpose of this research is to review the available information about the epidemiology of recurrent ACL injuries.…”