Patients with focal full-thickness cartilage lesions benefit less from ACL reconstruction at 2–5 years follow-up

Abstract

Purpose

To investigate differences in patient-reported outcome after anterior cruciate ligament (ACL) reconstruction between patients with and without a concomitant full-thickness cartilage lesion.

Methods

30 primary ACL-reconstructed patients with an isolated concomitant full-thickness cartilage lesion and 59 matched controls without cartilage lesions were identified in the Norwegian National Knee Ligament Registry and included in the present study. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was used as the outcome measure. At a median follow-up of 2.1 years (range, 2–5 years) after ACL reconstruction, 80 (90%) of the patients completed the KOOS.

Results

Preoperatively, there were no differences in KOOS between the study group and the control group. At follow-up, patients with full-thickness cartilage lesions reported significantly decreased scores compared to patients without cartilage lesions in the KOOS subscales pain (mean difference, 8.1; 95% confidence interval [CI], 0.8–15.3), activities in daily living (mean difference, 5.8; 95% CI, 0.3–11.2), sport/recreation (mean difference, 19.8; 95% CI, 5.3–34.3) and quality of life (mean difference, 17.2; 95% CI, 4.2–30.1). Patients with full-thickness cartilage lesions reported significantly less improvement from preoperative to follow-up than patients without cartilage lesions for the KOOS subscales pain (mean difference, 11.6; 95% CI, 3.2–19.9), sport/recreation (mean difference, 20.6; 95% CI, 8.1–33.1) and quality of life (mean difference, 16.3; 95% CI, 3.8–28.7).

Conclusions

ACL-injured patients with full-thickness cartilage lesions reported worse outcomes and less improvement after ACL reconstruction than those without cartilage lesions at 2–5 years follow-up.

Level of evidence

Prognostic; prospective cohort study, Level I.

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Acknowledgments

We would like to thank The National Knee Ligament Registry in Norway for providing the data for the current study; PT Vegar Hjermundrud, Akershus University Hospital for his work on the index study; the Norwegian Sports Medicine Association Research Grant and Eckboe’s Research Grant for funding the index study; MD, PhD Einar A. Sivertsen at Department of Orthopedic Surgery, Akershus University Hospital for statistical advice and his review of the manuscript; Oslo Sports Trauma Research Center for advisory support; and Akershus University Hospital and South-Eastern Norway Regional Health Authority for economic support while conducting the current study.

Conflict of interest

The authors declare no conflicts of interest.

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Correspondence to Jan Harald Røtterud.

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Røtterud, J.H., Risberg, M.A., Engebretsen, L. et al. Patients with focal full-thickness cartilage lesions benefit less from ACL reconstruction at 2–5 years follow-up. Knee Surg Sports Traumatol Arthrosc 20, 1533–1539 (2012). https://doi.org/10.1007/s00167-011-1739-y

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Keywords

  • Anterior cruciate ligament
  • Cartilage lesion
  • Outcome
  • KOOS