Anatomic risk factor for meniscal lesion in association with ACL rupture

To assess anatomic risk factors for meniscal lesions in association with acute ACL rupture. The primary hypothesis was that tibiofemoral anatomic measures will be different in those with and without concomitant meniscus tears.

A retrospective review of patients who underwent acute ACL reconstruction in the department was performed. All patients underwent a postoperative CT scan. The concavity and/or convexity on the femur and the tibia were measured by two blinded observers on the sagittal plane with different ratios, and these measures were compared in patients with and without meniscus tears in each compartment. Intra- and inter-rater reliabilities were assessed.

Four hundred twelve patients (268 males and 144 females) were included from October 2012 to February 2015. One hundred sixty-seven patients had a medial meniscal tear (119 males/48 females), and 100 had a lateral meniscal tear (80 males/20 females). The mean time from injury to surgery was 3 months. The average ICC for all measurements was 0.87 (range 0.82-0.98) indicating good reliability. The medial femoral condyle was noted to be significantly longer than the medial tibial plateau in the sagittal plane in patients with a medial meniscal tear (p = 0.04), and the lateral femoral condyle was noted to be significantly longer than the lateral tibial plateau in the sagittal plane in patients with a lateral meniscal tear (p <  0.001). In addition, a less convex lateral tibial plateau was statistically correlated with a higher risk of lateral meniscal tear (p = 0.001).

A greater anteroposterior length of the medial/lateral femoral condyle relative to the medial/lateral tibial plateau is associated with an increased risk of meniscal lesions in association with acute ACL rupture. The lateral compartment in the male population appears to be the most at risk.

Retrospectively registered on May 12, 2016 (CPP sud-est II CAL n°2016-037).