Delay in ACL reconstruction is associated with more severe and painful meniscal and chondral injuries

Abstract

PURPOSE: The goal of our study was to investigate the associations between surgical delay, pain and meniscus, and articular cartilage lesions seen at the time of ACL reconstruction. METHODS: One hundred and sixty-two consecutive patients who had received ACL reconstruction were recruited. The preoperative International Knee Documentation Committee (IKDC) questionnaires, and cartilage and meniscal lesions seen at the time of surgery were analysed. RESULTS: Patients with surgery within 12 months were less likely to have meniscus injury (59.8/77.4 %, p = 0.032), and the meniscus injury was more likely to be salvageable. (56.3/36.0 %, p = 0.042). Patients with meniscal tear larger than 10 mm had higher pain intensity than tear <10 mm (mean 6.8/8.2, p = 0.007). Patients older than 35 years of age were more likely to suffer from cartilage injury (76.4/39.1 %, p = 0.004). Patients with cartilage lesions had longer surgical delay (mean 18.9/12.1 months, p = 0.033). The presence of meniscal tear increased the risk of cartilage lesions (p = 0.038, OR = 2.14). Patients with cartilage lesions had a greater pain frequency (mean 6.9/7.7, p = 0.048). Moderate correlation was found between the size of cartilage lesion and the frequency of pain (p = 0.013). CONCLUSIONS: Increased surgical delay was associated with an increased incidence of meniscus and articular cartilage injuries in patients suffering from ACL tear; also, the meniscus was less likely to be salvageable. The presence of cartilage lesions was associated with an increased frequency of pain. Size of meniscal and cartilage lesions was significantly associated with pain. LEVEL OF EVIDENCE: Retrospective comparative study, Level III.