Abstract
This study aims to determine whether surgery for cruciate ligament (anterior or posterior)
or meniscus injury increased risks of subsequent comorbidities in beneficiaries of
the Military Health System. The study was a retrospective case-control design in which
individuals with cruciate or meniscus injuries were divided into two groups (surgery
or none). Data were pulled 12 months prior and 24 months following each respective
event and presence of comorbidities were compared between the two groups. Bivariate
analyses and logistic regression were used to determine if surgery increased the odds
of comorbidities. Participants included 1,686 with a cruciate ligament injury (30.1%
treated surgically) and 13,146 with a meniscus injury (44.4% treated surgically).
Bivariate comparisons of surgery versus nonsurgical treatment found multiple significant
differences. After adjusting for covariates, a significant (p < 0.05) protective effect was seen only for meniscus surgery for concussion, insomnia,
other mental health disorders, depression, and substance abuse. Surgery had no increased/decreased
risk of comorbidities for cruciate ligament injuries. For meniscus injuries, surgery
demonstrated a protective effect for six of the comorbidities we assessed. The treatment
approach (surgery vs. nonsurgical) did not change the risk of comorbidities in those
with a cruciate ligament injury. It is noteworthy that three of the six comorbidities
involved mental health disorders. Although the study design does not allow for determination
of causation, these findings should compel future prospective study designs that could
confirm these findings.
Keywords
knee surgery - cruciate ligament - meniscus surgery - knee
