Summary
The rate of chondral lesions and meniscal tears are higher in patients undergoing a second ACL revision reconstruction compared to those undergoing a single ACL revision reconstruction, ranging from half to 85% of cases
Abstract
Purpose
This study aims to describe the prevalence of meniscal and chondral lesions in patients undergoing a single revision Anterior Cruciate Ligament (ACL) reconstruction versus those undergoing second ACL revision reconstructions.
Materials And Methods
A retrospective single-center study from 2012 to 2022 was conducted, involving patients who underwent at least one ACL revision reconstruction. Inclusion criteria were all patients aged between 16 and 60 years which had a previous ACL reconstruction. Exclusion criteria were multi-ligament knee injuries, concomitant osteotomies and 3 or more previous ACL reconstructions.
Results
A total of 257 patients meeting inclusion and exclusion criteria with at least one revision of ACL reconstruction were identified. Of these, 204 patients were included in the single revision group (R1), and 51 patients in the second revisions group (R2). Two patients who underwent a third revision of ACLR were excluded. Prevalence of chondral lesions were 47.6% in the single revision group (R1) and 64.7% in the second revision group (R2) (p=0.045). There was a higher prevalence of medial and lateral compartment chondral lesions in the R2 group (56.9% and 39.2% respectively) compared to the R1 group (36.3% and 13.5%) (p=0.012 and p=0.001). Medial meniscal tears were observed in 51% of the R1 group and 78% of the R2 group (p < 0.001). There was no difference in meniscal treatment type in the medial and lateral compartment between the R1 and R2 groups.
Conclusion
The rate of chondral lesions and meniscal tears were higher in patients undergoing a second ACL revision reconstruction compared to those undergoing a single ACL revision reconstruction, ranging from half to 85% of cases. There was a higher rate of medial and lateral compartment chondral injuries in the second ACL revision reconstruction group compared to the single ACL revision reconstruction group, with a nearly threefold higher rate in the lateral compartment.