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Lesion size and varus malalignment are the major determinants leading to poorer clinical outcomes after combined microfracture treatment for focal cartilage lesions during anterior cruciate ligament reconstruction

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

The purposes of this study were to evaluate the clinical effects of microfracture (MFX) performed for Outerbridge grade 3 or 4 focal cartilage lesion during the same surgery with arthroscopic anterior cruciate ligament (ACL) reconstruction and to analyze the major determinants of these potential effects on the clinical outcome. The clinical and radiographic data of 119 patients were evaluated. The mean follow-up time was 32.6 ± 6 months. Isolated arthroscopic ACL reconstruction was performed in 70 patients (Group 1), whereas MFX for Outerbridge grade 3 or 4 chondral lesion during ACL surgery was performed in 49 patients (Group 2). Visual analogue scale (VAS) score, Lysholm knee score, and Tegner activity scale were the instruments used as outcome measures to evaluate the clinical status of the patients. Routine X-ray and MRI were also performed for all patients pre-operatively as well as at the latest follow-up visit. Lineer regression analysis was performed to determine major factors predicting the poorer clinical outcome. Clinical outcomes were similar between isolated ACL reconstruction and combined procedure. On the other hand, according to lineer regression analysis, cartilage lesion size > 2 cm2 and > 5 degrees of varus alignment were detected as the major determinants leading to poorer outcomes in combined ACL reconstruction and MFX.

Level of evidence: III – Retrospective Comparative Study.

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Authors and Affiliations

  1. Orthopedics and Traumatology, Altinbas University Faculty of Medicine, Istanbul, Turkey

    Hakan Sofu

  2. Orthopedics and Traumatology, Liv Hospital, Istinye University, Istanbul, Turkey

    Gurkan Gumussuyu

  3. Orthopedics and Traumatology, Memorial Health Group Sisli Hospital, Istanbul, Turkey

    Olcay Guler

  4. Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Hospital, Istanbul, Turkey

    Hanifi Ucpunar

  5. Orthopedics and Traumatology, Diyarbakir Selahaddin Eyyubi State Hospital, Diyarbakir, Turkey

    Serda Duman

  6. Orthopedics and Traumatology, Aritmi Hospital Group, Bursa, Turkey

    Yalkin Camurcu

  7. Altinbas University MedicalPark Bahcelievler Hospital, Bahcelievler mahallesi E-5 Yan yolu Kultur sokak No: 1, 34160, Istanbul, Turkey

    Hakan Sofu

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  1. Hakan Sofu
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  2. Gurkan Gumussuyu
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  4. Hanifi Ucpunar
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Correspondence to Hakan Sofu.

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Sofu, H., Gumussuyu, G., Guler, O. et al. Lesion size and varus malalignment are the major determinants leading to poorer clinical outcomes after combined microfracture treatment for focal cartilage lesions during anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 142, 1941–1949 (2022). https://doi.org/10.1007/s00402-021-04138-x

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  • DOI: https://doi.org/10.1007/s00402-021-04138-x

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