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Previous meniscectomy linked with chondral lesions in ACL reconstruction

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SAN FRANCISCO — Previous partial meniscectomy led to a higher rate of chondral lesions found at the time of revision ACL reconstruction, according to Robert H. Brophy, MD, who presented his findings here at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting.

“When we adjusted for age and looked at the knee overall, we found that partial meniscectomy had a higher incidence of chondrosis than knees without previous surgery,” Brophy said.

Brophy and colleagues used data from the prospective Multicenter ACL Revision Study (MARS) to identify 725 revision ACL surgeries in patients with a mean age of 25 years.

“Knees undergoing ACL reconstruction have been shown to have a high incidence of chondral injuries in studies previously published […], however the risk factors for these lesions in this cohort are not well understood,” Brophy said. “Our hypothesis was that previous partial meniscectomy would be associated with a higher incidence of chondral lesions at the time of revision ACL reconstruction, but that meniscal repair would not be associated with the chondrosis.”

Of the group, there were 421 male patients. The investigators examined the data for Grades II, III and IV chondral lesions. Patients that underwent previous partial meniscal surgery and were undergoing ACL reconstruction had a higher grade of chondral lesions than patients who underwent no meniscal surgery.

“The reason for meniscal repair not being associated with chondrosis are not clear,” Brophy said. “Certainly, differences in underlying injuries to the knee, either at the time of recurring ACL injury, or previous injury to the knee. Although it is certainly a possibility that repair is perhaps somewhat protective, but certainly not to be precluded from association in this study.”

Reference:

• Brophy RH, David TS, Sekiya JK, et al. Previous partial meniscectomy increases incidence of chondrosis at revision ACL reconstruction in MARS cohort. Paper #545. Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb 7-11. San Francisco.
• Disclosure: Brophy is a paid consultant for Stryker and DePuy.

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