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Meniscal status, limb alignment, BMI correlated with chondrosis at revision ACL surgery
During revision ACL reconstruction the status of the articular cartilage of the tibiofemoral compartments was associated with meniscal status in this study and medial compartment chondrosis was found to correlate with lower extremity alignment and BMI.
Researchers reviewed 246 patients in a Multicenter ACL Revision study group (26.9 years old, mean) who had lower extremity alignment films and revision ACL reconstruction. Bilateral long-leg standing radiographs were used to measure limb alignment.
During surgery, surgeons noted the presence of meniscal and chondral injuries.
Researchers used the Outerbridge classification system to describe the chondral status as normal, intermediate or advanced. The two dependent variables studied were medial compartment and lateral compartment chondrosis. For independent controls they used age, sex, BMI, activity level, number of revisions, previous ACL graft type, lower extremity alignment and meniscal compartment status.
The findings showed there was more medial compartment chondrosis than lateral compartment chondrosis and investigators observed medial-side meniscus disruption in 35% of patients and lateral-side disruption in 16% of patients
According to the researchers, BMI, alignment and medial meniscus status were correlated with medial compartment chondrosis. With each higher BMI unit, the chance of medial compartment chondrosis increased by 8% while chances decreased by 64% with an intact medial meniscus. The risk for medial compartment chondrosis decreased by 9.7% when weight bearing line on the lateral side shifted 10%.
Age and lateral meniscal status were significantly correlated with lateral compartment chondrosis. With increased patient age, the chances of lateral compartment chondrosis increased by 4% while lateral compartment chondrosis decreased by 84% with an intact lateral meniscus status. ‒ by Monica Jaramillo
Disclosure: Brophy reports he is on the editorial/governing board of the American Journal of Sports Medicine, he is a board or committee member for the American Orthopaedic Society for Sports Medicine, and he is a paid consultant for ISTO Technologies. He reports he is a board or committee member for Orthopaedic Research Society and has stock and stock options in Ostesys.