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Good results five years after surgical management of anterior cruciate ligament tears, and meniscal and cartilage injuries

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

In athletes with anterior cruciate ligament (ACL) tears combined with meniscal and cartilage injuries, the goals are to restore knee laxity and relieve symptoms, while long-term goals are the return to pre-injury sport activity and to prevent onset of degenerative changes. We compared the post-operative (minimum 5 years) clinical and radiological outcomes of 50 patients, similar for ACL rupture and meniscal tears, but different for the grade of cartilage lesion. The patient population was divided into two groups similar for ACL reconstruction and surgical meniscal management. Group 1 included 25 patients undergoing microfracture management of grade III–IV cartilage lesions, while Group 2 included 25 patients with grade I–II cartilage lesions, managed by radiofrequency. Comparing pre- and post-operative status, Lachman test, pivot shift values and KT 1000 side to side difference measurements improved significantly (<.001) in both groups, with NS difference between the two groups (>0.05) at the intermediate and latest assessments. At both post-operative appointments, in both groups, the average Lysholm score and IKDC ranking rates improved significantly (<0.001) compared to pre-operative values, but slight worsening was observed in Group 1 patients at the latest review. At the latest assessment, 10 knees (40%) in Group 1 and 3 knees (15%) in Group 2 demonstrated degenerative changes according to Fairbank grading. Concerning the WOMAC index score and sport activity level rating, Group 1 patients had significantly lower scores than Group 2 patients (P < 0.05). In patients with symptomatic ACL instability combined to grade III–IV cartilage lesions, microfractures give excellent short-term clinical and functional improvement but do not prevent the evolution of degenerative changes.

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Authors and Affiliations

  1. Unit of Arthroscopy and Sports Trauma Surgery, Hesperia Hospital, Via Arquà 80/b, Modena, Italy

    Leonardo Osti

  2. Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy

    Rocco Papalia, Angelo Del Buono, Cirino Amato & Vincenzo Denaro

  3. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, UK

    Nicola Maffulli

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  1. Leonardo Osti
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Correspondence to Nicola Maffulli.

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Osti, L., Papalia, R., Del Buono, A. et al. Good results five years after surgical management of anterior cruciate ligament tears, and meniscal and cartilage injuries. Knee Surg Sports Traumatol Arthrosc 18, 1385–1390 (2010). https://doi.org/10.1007/s00167-009-1035-2

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  • DOI: https://doi.org/10.1007/s00167-009-1035-2

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