Prevalence of Medial Meniscus Injury After Delayed ACL Reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Knee Biomechanics

Background:

• Menisci are key knee stabilizers, and anterior cruciate ligament (ACL) tears often coexist with meniscal injuries.
• Previous research suggests delays of 12 months or more in ACL-deficient knees correlate with new meniscal pathology.
• Predictive factors and optimal timing for intervention, particularly in younger populations, require further definition.

Purpose of the Study:

• To investigate the relationship between surgical timing, patient demographics, and the characteristics of meniscal pathology in individuals undergoing ACL reconstruction.
• To identify patient-related factors influencing meniscal tear extent and location following ACL injury.

Main Methods:

• A multicenter retrospective cohort study involving 2033 patients (aged 9-73 years) who underwent ACL reconstruction between 2013 and 2023.
• Analysis utilized multivariable logistic regression to model meniscal tear patterns based on age, sex, activity level, and the interval between injury and surgery.
• Study design classified as prognosis with a level of evidence of 3.

Main Results:

• Delayed ACL reconstruction (defined as >120 days post-injury) was significantly associated with a higher prevalence of medial meniscus tears (P < .001).
• Delayed surgery increased the odds of medial meniscus tears by 80% (aOR, 1.80) and combined medial and lateral tears by 47% (aOR, 1.47).
• Male sex demonstrated a higher prevalence of meniscal tears across all time points, with significantly increased odds for medial (aOR, 1.43), lateral (aOR, 1.61), and combined tears (aOR, 1.50) compared to females.

Conclusions:

• Prompt surgical intervention for ACL injuries is essential to prevent further intra-articular damage, including progressive meniscal pathology.
• Male athletes and individuals facing delays in surgical treatment require particular attention due to their elevated risk of meniscal tears.
• These findings underscore the importance of timely ACL reconstruction for optimal knee joint preservation.