Original Article
Anterior Cruciate Ligament Reconstruction After 10 to 15 Years: Association Between Meniscectomy and Osteoarthrosis

https://doi.org/10.1016/j.arthro.2007.03.094Get rights and content

Purpose: To evaluate the stability and arthrosis of the knee 10 to 15 years after arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction with patellar tendon graft. Methods: From July 1986 to March 1991, 82 patients underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft. Of these, 62 returned for follow-up evaluation between November 2000 and April 2001. Four different physicians, blinded to each other’s examination findings, evaluated the radiologic as well as surgical results according to the International Knee Documentation Committee criteria and the Lysholm knee scoring scale. Results: There were 47 male and 15 female patients. The mean period between injury and surgery was 16 months (range, 2 weeks to 8 years). Results of radiographs were compared with the finding of meniscal lesions during surgery and with International Knee Documentation Committee test results. A statistically significant association (P < .0001) was found between medial or lateral arthrosis of the knee and meniscal injury. In all patients the presence of tears in both menisci was associated with osteoarthrosis in both compartments (medial and lateral). Conclusions: In patients who underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft who also had medial or lateral meniscectomy (or both), arthrosis of the respective compartments developed by 10 to 15 years after reconstruction. Meniscectomy was also associated with poorer results on objective tests of knee function, even with a stable knee joint. Level of Evidence: Level IV, therapeutic case series.

Section snippets

Methods

From July 1986 through March 1991, 126 consecutive patients underwent arthroscopic-assisted ACL reconstruction with patellar tendon autograft. Excluded from this retrospective study were patients with bilateral ACL reconstruction (n = 12), previous knee surgery (n = 18), degenerative changes and grade III or IV chondromalacia found radiographically or at the time of surgery (n = 11), and other ligament injuries associated with the ACL injury (posterior cruciate ligament [n = 1] and

Results

There were 47 male patients and 15 female patients. The mean age at surgery was 27 years (range, 15 to 46 years); most patients (n = 59) were aged less than 40 years at the time of surgery. One patient was injured as the result of a fall; all others were injured during sporting activities. Patients were operated on at a mean of 16 months after the initial injury (range, 2 weeks to 8 years). During the initial surgery, meniscal lesions were found in 41 knees: 22 had isolated medial meniscus

Discussion

In this study the knees of patients who underwent arthroscopic-assisted ACL reconstruction with a patellar tendon autograft with concurrent medial or lateral meniscectomy for meniscal lesions presented with arthrosis of the respective compartments at 10 to 15 years of follow-up. Meniscectomy was also associated with poorer results on objective tests of knee function, even when the knee joint was stable. The strength of this study lies in the length of the postoperative follow-up, the patient

Conclusions

Patients who underwent arthroscopic-assisted ACL reconstruction with patellar tendon graft who had concurrent medial or lateral meniscectomies (or both) presented with arthrosis in the respective compartments at 10 to 15 years of follow-up. Meniscectomy was the determining factor for arthrosis. Meniscectomy was also associated with poorer results on objective tests of knee function, even when the knee joint was stable.

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    The authors report no conflict of interest.

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