Anterior cruciate ligament tear in Hong Kong Chinese patients

Abstract

Objective: To investigate the associations between patient sex, age, cause of injury, and frequency of meniscus and articular cartilage lesions seen at the time of the anterior cruciate ligament reconstruction. Design: Case series. Setting: University affiliated hospital, Hong Kong. Patients: Medical notes and operating records of 672 Chinese patients who had received anterior cruciate ligament reconstruction between January 1997 and December 2010 were reviewed. Data concerning all knee cartilage and meniscus injuries documented at the time of surgery were analysed. Results: Of the 593 patients, meniscus injuries were identified in 315 (53.1%). Patients older than 30 years were more likely to suffer from meniscal injury compared with those younger than 30 years (60% vs 51%, P=0.043). Longer surgical delay was observed in patients with meniscal lesions compared with those without (median, 12.3 months vs 9.1 months, P=0.021). Overall, 139 cartilage lesions were identified in 109 (18.4%) patients. Patients with cartilage lesions were significantly older than Introduction Anterior cruciate ligament (ACL) tear is one of the commonest sport injuries seen in clinical practice, and such injury is often associated with meniscal and chondral lesions. It is widely believed that early surgery can prevent such lesions in ACL-deficient patients, and probably help avoid the most dreadful complication of early osteoarthritis of the knee.1 Despite multiple studies conducted to evaluate the relationship between intra-articular injuries and ACL tear, such associations among Asians, especially Chinese, have not been extensively studied. Data show that females are more susceptible to ACL injury than their male counterparts,2-4 but lower risk of other intra-articular injuries in females was observed in some studies.5 Furthermore, a those without the lesions (mean, 27.6 years vs 25.1 years, P=0.034). Male patients were more likely to have chondral injuries than female patients (20.1% vs 10.9%, P=0.028). The risk of cartilage lesions was increased by nearly 3 times in the presence of meniscal tear (P<0.0001; odds ratio=2.7; 95% confidence interval, 1.7-4.2). Conclusions: Increased age and surgical delay increased the risk of meniscal tears in patients with anterior cruciate ligament tear. Increased age, male sex, and presence of meniscal tear were associated with an increased frequency of articular lesions after an anterior cruciate ligament tear.