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J Knee Surg 2022; 35(11): 1175-1180
DOI: 10.1055/s-0042-1748173
Special Focus Section

Characterization of Cartilage Injury and Associated Treatment at the Time of Primary Anterior Cruciate Ligament Reconstruction

Patrick K. Mescher 
1   Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Ashley B. Anderson
1   Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Travis J. Dekker
2   Department of Orthopaedic Surgery, 96th Medical Group US Air Force Eglin Regional Hospital, Eglin AFB, Florida
,
Veronika Pav
3   School of Public Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
,
Jonathan F. Dickens
4   Department of Orthopedics, Walter Reed Army Medical Center, Bethesda, Maryland
5   Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, Maryland
› Author Affiliations Funding None.
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Abstract

Anterior cruciate ligament (ACL) tears with concomitant cartilage injuries resulting in ACL reconstruction (ACLR) with cartilaginous procedures are common in the young, high-demand population. The purpose of this study was to report and characterize cartilage treatments performed at the time of index ACLR reconstruction and to determine if those treatments are associated with revision surgery (of any kind) in the 4-year follow-up. We performed a consecutive series of active duty service members in the Military Health System Data Repository with ACLR with and without concomitant cartilage procedures done at military facilities between October 2008 and September 2011. Patients were continuously enrolled with no history of knee surgeries for 2 years prior to primary ACLR. ACLR failure was defined as revision ACLR within 4 years following the primary ACLR. Of the 2,735 primary ACLRs included in the study, 5.3% (143/2,735) underwent isolated ACLR with a cartilage procedure. Of these patients, 23.07% (33/143) experienced ACLR failure within 4 years after ACLR with cartilage procedures, including 33.33% (11/33) undergoing revision ACLR. We found concomitant cartilage procedures at time of index ACLR to have the following rates of revision 35.59% (21/59) for microfracture, 14.63% (6/41) for chondroplasty, and 13.95% (6/43) for osteochondral grafts. The overall clinical failure rate of service members with ACLR plus concomitant cartilage procedure is 23.07% with minimum 4-year follow-up. Further research should be done to identify modifiable demographic and surgical factors associated with failure. This is a retrospective case-control study that reflects level of evidence III.

Keywords

anterior cruciate ligament - anterior cruciate ligament reconstruction with cartilage injury - anterior cruciate ligament reconstruction - incidence of chondral injury with ACL rupture

Mandatory Institutional Disclaimer

The views expressed in this manuscript reflect the results of research conducted by the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.




Publication History

Received: 15 February 2022

Accepted: 23 February 2022

Article published online:
01 June 2022

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