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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2015

01.03.2015 | Knee

The evaluation of patient-specific factors associated with meniscal and chondral injuries accompanying ACL rupture in young adult patients

verfasst von: Gang Chen, Xing Tang, Qi Li, Guo Zheng, Tianfu Yang, Jian Li

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 3/2015

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Abstract

Purpose

To evaluate patient-specific factors, including the mechanism of injury, time from the injury, activity level after the initial trauma, re-injury and body mass index (BMI), as risk factors for meniscal and chondral injuries accompanying anterior cruciate ligament (ACL) rupture.

Methods

A retrospective review of young adult patients with complete ACL rupture was performed between 2007 and 2011. The presence of meniscal tears and/or chondral injury, and the mechanism of injury, time from the injury, activity level after the initial trauma, re-injury and BMI were recorded. The data were analysed for associations between patient-specific factors and the prevalence of meniscal and chondral injuries.

Results

A total of 293 patients were included. Increasing time from the injury, active daily life and re-injury were risk factors associated with meniscal injuries (p < 0.05). Independent risk factors associated with meniscal injuries included active daily life (OR = 4.66, 95 % CI 2.21–9.86, p < 0.0001) and re-injury (OR = 7.68, 95 % CI 3.24–18.22, p < 0.0001). Contact injury, increasing time from the injury, active daily life and re-injury were risk factors associated with chondral injuries (p < 0.05). Independent risk factors associated with chondral injuries included contact injury (OR = 2.54, 95 % CI 1.27–5.10, p < 0.01), active daily life (OR = 2.62, 95 % CI 1.35–5.08, p < 0.01) and re-injury (OR = 4.18, 95 % CI 2.09–8.35, p < 0.001). The incidence of re-injury was associated with the activity level (p < 0.001) and increased with increasing time from the injury (r = −0.698, p < 0.001).

Conclusions

An increased risk of meniscal tear (especially medial meniscus) was strongly associated with an active daily life and re-injury. The combination of contact injury, active daily life and re-injury substantially increased the risk of cartilage injury. Patients with increasing time from the injury and active daily life exhibited a higher risk of re-injury, implying a higher prevalence of intra-articular damage.

Level of evidence

Cross-sectional study, Level III.
Literatur
1.
Zurück zum Zitat Bernstein J (2011) Early versus delayed reconstruction of the anterior cruciate ligament: a decision analysis approach. J Bone Joint Surg Am 93:e48PubMed Bernstein J (2011) Early versus delayed reconstruction of the anterior cruciate ligament: a decision analysis approach. J Bone Joint Surg Am 93:e48PubMed
2.
Zurück zum Zitat Butler DL, Kappa Delta Award paper (1989) Anterior cruciate ligament: its normal response and replacement. J Orthop Res 7:910–921CrossRefPubMed Butler DL, Kappa Delta Award paper (1989) Anterior cruciate ligament: its normal response and replacement. J Orthop Res 7:910–921CrossRefPubMed
3.
Zurück zum Zitat Chhadia AM, Inacio MC, Maletis GB, Csintalan RP, Davis BR, Funahashi TT (2011) Are meniscus and cartilage injuries related to time to anterior cruciate ligament reconstruction? Am J Sports Med 39:1894–1899CrossRefPubMed Chhadia AM, Inacio MC, Maletis GB, Csintalan RP, Davis BR, Funahashi TT (2011) Are meniscus and cartilage injuries related to time to anterior cruciate ligament reconstruction? Am J Sports Med 39:1894–1899CrossRefPubMed
4.
Zurück zum Zitat Dumont GD, Hogue GD, Padalecki JR, Okoro N, Wilson PL (2012) Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med 40:2128–2133CrossRefPubMed Dumont GD, Hogue GD, Padalecki JR, Okoro N, Wilson PL (2012) Meniscal and chondral injuries associated with pediatric anterior cruciate ligament tears: relationship of treatment time and patient-specific factors. Am J Sports Med 40:2128–2133CrossRefPubMed
5.
Zurück zum Zitat Fithian DC, Paxton LW, Goltz DH (2002) Fate of the anterior cruciate ligament injured knee. Orthop Clin N Am 33:621–636CrossRef Fithian DC, Paxton LW, Goltz DH (2002) Fate of the anterior cruciate ligament injured knee. Orthop Clin N Am 33:621–636CrossRef
6.
Zurück zum Zitat Fok AW, Yau WP (2013) Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries. Knee Surg Sports Traumatol Arthrosc 21:928–933CrossRefPubMed Fok AW, Yau WP (2013) Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries. Knee Surg Sports Traumatol Arthrosc 21:928–933CrossRefPubMed
7.
Zurück zum Zitat Gadeyne S, Besse JL, Galand-Desme S, Lerat JL, Moyen B (2006) Analysis of meniscal lesions accompanying anterior cruciate ligament tears: a retrospective analysis of 156 patients. Rev Chir Orthop Reparatrice Appar Mot 92:448–454CrossRefPubMed Gadeyne S, Besse JL, Galand-Desme S, Lerat JL, Moyen B (2006) Analysis of meniscal lesions accompanying anterior cruciate ligament tears: a retrospective analysis of 156 patients. Rev Chir Orthop Reparatrice Appar Mot 92:448–454CrossRefPubMed
8.
Zurück zum Zitat Granan LP, Bahr R, Lie SA, Engebretsen L (2009) Timing of anterior cruciate ligament reconstructive surgery and risk of cartilage lesions and meniscal tears: a cohort study based on the Norwegian National Knee Ligament Registry. Am J Sports Med 37:955–961CrossRefPubMed Granan LP, Bahr R, Lie SA, Engebretsen L (2009) Timing of anterior cruciate ligament reconstructive surgery and risk of cartilage lesions and meniscal tears: a cohort study based on the Norwegian National Knee Ligament Registry. Am J Sports Med 37:955–961CrossRefPubMed
9.
Zurück zum Zitat Hootman JM, Dick R, Agel J (2007) Epidemiology of collegiate injuries for 15 sports: summary and recommendations of injury prevention initiatives. J Athl Train 42:311–319PubMedCentralPubMed Hootman JM, Dick R, Agel J (2007) Epidemiology of collegiate injuries for 15 sports: summary and recommendations of injury prevention initiatives. J Athl Train 42:311–319PubMedCentralPubMed
10.
Zurück zum Zitat Kaeding CC, Pedroza AD, Parker RD, Spindler KP, McCarty EC, Andrish JT (2005) Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy 4:424–430CrossRef Kaeding CC, Pedroza AD, Parker RD, Spindler KP, McCarty EC, Andrish JT (2005) Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy 4:424–430CrossRef
11.
Zurück zum Zitat Keene GC, Bickerstaff D, Rae PJ, Paterson RS (1993) The natural history of meniscal tears in anterior cruciate ligament insufficiency. Am J Sports Med 21:672–679CrossRefPubMed Keene GC, Bickerstaff D, Rae PJ, Paterson RS (1993) The natural history of meniscal tears in anterior cruciate ligament insufficiency. Am J Sports Med 21:672–679CrossRefPubMed
12.
Zurück zum Zitat Kessler MA, Behrend H, Henz S, Stutz G, Rukavina A, Kuster MS (2008) Function, osteoarthritis and activity after ACL-rupture: 11 years follow-up results of conservative versus reconstructive treatment. Knee Surg Sports Traumatol Arthrosc 16:442–448CrossRefPubMed Kessler MA, Behrend H, Henz S, Stutz G, Rukavina A, Kuster MS (2008) Function, osteoarthritis and activity after ACL-rupture: 11 years follow-up results of conservative versus reconstructive treatment. Knee Surg Sports Traumatol Arthrosc 16:442–448CrossRefPubMed
13.
Zurück zum Zitat Lawrence JT, Argawal N, Ganley TJ (2011) Degeneration of the knee joint in skeletally immature patients with a diagnosis of an anterior cruciate ligament tear: is there harm in delay of treatment? Am J Sports Med 39:2582–2587CrossRefPubMed Lawrence JT, Argawal N, Ganley TJ (2011) Degeneration of the knee joint in skeletally immature patients with a diagnosis of an anterior cruciate ligament tear: is there harm in delay of treatment? Am J Sports Med 39:2582–2587CrossRefPubMed
14.
Zurück zum Zitat Levy BA (2010) Is early reconstruction necessary for all anterior cruciate ligament tears? N Engl J Med 363:386–388CrossRefPubMed Levy BA (2010) Is early reconstruction necessary for all anterior cruciate ligament tears? N Engl J Med 363:386–388CrossRefPubMed
15.
Zurück zum Zitat Maffulli N, Binfield PM, King JB (2003) Articular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee. Arthroscopy 19:685–690CrossRefPubMed Maffulli N, Binfield PM, King JB (2003) Articular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee. Arthroscopy 19:685–690CrossRefPubMed
16.
Zurück zum Zitat O’Connor DP, Laughlin MS, Woods GW (2005) Factors related to additional knee injuries after anterior cruciate ligament injury. Arthroscopy 21:431–438CrossRefPubMed O’Connor DP, Laughlin MS, Woods GW (2005) Factors related to additional knee injuries after anterior cruciate ligament injury. Arthroscopy 21:431–438CrossRefPubMed
17.
Zurück zum Zitat Piasecki DP, Spindler KP, Warren TA, Andrish JT, Parker RD (2003) Intraarticular injuries associated with anterior cruciate ligament tear: findings at ligament reconstruction in high school and recreational athletes. An analysis of sex-based differences. Am J Sports Med 31:601–605PubMed Piasecki DP, Spindler KP, Warren TA, Andrish JT, Parker RD (2003) Intraarticular injuries associated with anterior cruciate ligament tear: findings at ligament reconstruction in high school and recreational athletes. An analysis of sex-based differences. Am J Sports Med 31:601–605PubMed
18.
Zurück zum Zitat Pujol N, Bianchi MP, Chambat P (2007) The incidence of anterior cruciate ligament injuries among competitive alpine skiers: a 25-year investigation. Am J Sports Med 35:1070–1074CrossRefPubMed Pujol N, Bianchi MP, Chambat P (2007) The incidence of anterior cruciate ligament injuries among competitive alpine skiers: a 25-year investigation. Am J Sports Med 35:1070–1074CrossRefPubMed
19.
Zurück zum Zitat Salata MJ, Gibbs AE, Sekiya JK (2010) A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 38:1907–1916CrossRefPubMed Salata MJ, Gibbs AE, Sekiya JK (2010) A systematic review of clinical outcomes in patients undergoing meniscectomy. Am J Sports Med 38:1907–1916CrossRefPubMed
20.
Zurück zum Zitat Slauterbeck JR, Kousa P, Clifton BC et al (2009) Geographic mapping of meniscus and cartilage lesions associated with anterior cruciate ligament injuries. J Bone Joint Surg Am 91:2094–2103CrossRefPubMed Slauterbeck JR, Kousa P, Clifton BC et al (2009) Geographic mapping of meniscus and cartilage lesions associated with anterior cruciate ligament injuries. J Bone Joint Surg Am 91:2094–2103CrossRefPubMed
21.
Zurück zum Zitat Tandogan RN, Taser O, Kayaalp A, Taskiran E, Pinar H, Alparslan B, Alturfan A (2004) Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc 12:262–270CrossRefPubMed Tandogan RN, Taser O, Kayaalp A, Taskiran E, Pinar H, Alparslan B, Alturfan A (2004) Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury, and level of sport. Knee Surg Sports Traumatol Arthrosc 12:262–270CrossRefPubMed
22.
Zurück zum Zitat Yüksel HY, Erkan S, Uzun M (2006) The evaluation of intraarticular lesions accompanying ACL ruptures in military personnel who elected not to restrict their daily activities: the effect of age and time from injury. Knee Surg Sports Traumatol Arthrosc 14:1139–1147CrossRefPubMed Yüksel HY, Erkan S, Uzun M (2006) The evaluation of intraarticular lesions accompanying ACL ruptures in military personnel who elected not to restrict their daily activities: the effect of age and time from injury. Knee Surg Sports Traumatol Arthrosc 14:1139–1147CrossRefPubMed
Metadaten
Titel
The evaluation of patient-specific factors associated with meniscal and chondral injuries accompanying ACL rupture in young adult patients
verfasst von
Gang Chen
Xing Tang
Qi Li
Guo Zheng
Tianfu Yang
Jian Li
Publikationsdatum
01.03.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 3/2015
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2718-2

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