Arthroscopic evaluation of the articular cartilage after anterior cruciate ligament reconstruction: A short-term prospective study of 105 patients

Presented at the 2001 Congress of ISAKOS, Montruex, Switzerland, May 2001.
https://doi.org/10.1016/j.arthro.2004.03.006Get rights and content

Abstract

Purpose: Several reports have shown the progression of degenerative osteoarthritis after anterior cruciate ligament (ACL) reconstruction. No report has been published about early cartilage change after ACL reconstruction. The purpose of this study was to evaluate the articular cartilage after ACL reconstruction in a short postoperative period by arthroscopy. Type of Study: Case series. Methods: We examined the status of articular cartilage of 105 patients who received ACL reconstruction and second-look arthroscopy. Cartilage lesion was evaluated arthroscopically in the 6 articular surfaces independently, and these features were classified by modified Outerbridge’s classification. We compared the articular cartilage at reconstruction and at second-look arthroscopy. Results: A significant worsening of the status of the articular cartilage was seen after ACL reconstruction. This worsening was seen at all articular surfaces except the lateral femoral condyle. Most of the change involved softening or fibrillation. Anterior laxity and meniscal lesion had no correlation with a progression of degenerative change of articular cartilage. Patient’s age influenced the progression of articular cartilage damage after reconstruction significantly in our cases. Conclusions: The status of articular cartilage was significantly worsened after ACL reconstruction. Potent risk factors causing articular cartilage damage include female gender and age of 30 years or older. Level of Evidence: Level IV.

Section snippets

Methods

One hundred and fifty-nine patients underwent arthroscopicly assisted ACL reconstruction for a unilateral ACL injury between May 1995 and December 1997 at our institution. Patients included 77 men and 82 women, ranging in age from 14 to 44 years (mean, 25.8 years).

General condition

Two patients complained of patellofemoral crepitus and mild pain. Second-look arthroscopy showed fibrillation of the articular cartilage of the patella and femoral groove. One patient complained of medial pain. Second-look arthroscopy showed fibrillation of the articular cartilage of MTP. The other patients had no pain of the knee. No formation of neuromas was found. Average KT-1000 side-to-side difference was 2.3 ± 1.8 (range, 1.5 to 5). Six patients showed negative values. No patients needed

Discussion

Whether surgical repair and stabilization actually reduce the incidence of post-traumatic osteoarthritis of the knee remains controversial. Several studies have reported that many knees with reconstructed ACL showed osteoarthritis after ACL reconstruction.6, 7, 8, 9 These studies reported that residual anterior laxity showed no correlation to the incidence of osteoarthritis. Several studies revealed risk factors of radiographic degenerative osteoarthritis after ACL reconstruction. Kullmer et al.

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