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Study finds no downside to leaving knee cartilage lesions untreated after ACL injury

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PRAGUE — A long-term follow-up of 43 patients who were treated for ACL tears but untreated for associated knee cartilage lesions showed that the group did just as well as patients without cartilage lesions who underwent similar ACL treatments.

Wojciech Widuchowski, MD, and colleagues included patients with Outerbridge grade 3 and 4 lesions in their investigation conducted from 1991 to 1995. They evaluated lesions with a mean size of 2.6 cm², most of which were on the medial femoral condyle.

“Our conclusions are these cartilage lesions found during ACL reconstruction left with no treatment do not appear to affect the clinical outcome at 10 and 15 year follow-up. Our study seems to reinforce the question whether treatment of a symptomatic lesion provides improvement over that of the natural history,” he said in a presentation at the SICOT XXV Triennial World Congress 2011, here.

Widuchowski noted that applying these findings could represent significant cost savings for health care systems and possibly reduce the tens of thousands of knee arthroscopy procedures done annually in the United States alone.

He said the patients were followed up at 10 and 15 years after ACL surgery using both domains of the IKDC score, the Lysholm score and Tegner activity scale.

At both follow-up time points, these outcome scores proved similar to those of a matched group of patients without cartilage lesions who also had ACL surgery and completed the same postoperative rehabilitation regimen.

Compared to the control group, “At both 10 and 15 years follow-up, we observed no significant correlation between lesion size and postoperative scores, lesion location and postoperative scores and lesion grade and postoperative scores,” Widuchowski said.

Reference:

• Widuchowski W, Lukasik P, Ryszard F, et al. Untreated deep cartilage lesions associated with ACL injury: Results at 10 and 15 years follow-up. Paper #28870. Presented at the SICOT XXV Triennial World Congress 2011. Sept. 6-9. Prague.
• Disclosure: Widuchowski has no relevant financial disclosures.

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