Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleArticular cartilage lesions in the symptomatic anterior cruciate ligament-deficient knee
Section snippets
Methods
All procedures described in this study were approved by the local Ethics Committee.
Time from injury to arthroscopy
A total of 202 articular cartilage lesions were found in 163 (43%) of the 378 knees included in this study (Fig 1). The average time from injury to arthroscopy in patients with a single definite injury was 23.6 months (range, 1 day to 16 years). We did not find any patient with Outerbridge grade I lesions (softening and swelling of the articular cartilage). In patients with articular cartilage lesions, the time from injury to arthroscopy was significantly greater when compared with patients
Discussion
The management of the unstable knee after an ACL tear is controversial, because both surgical and nonsurgical treatment may result in an increased rate of articular cartilage degeneration.12, 13, 14, 15, 16, 17, 18 In this study, we concentrated on the frequency of arthroscopically evident lesions of the articular cartilage, because they are likely to constitute the final result of an intra-articular insult8 and the first macroscopic step towards the development of degenerative joint disease.19
Acknowledgements
Many thanks are given to Miss Linda Lothian for her help in preparing the manuscript.
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2021, KneeCitation Excerpt :It is well known that ACL and its related structures play a crucial role in maintaining the anterior–posterior, medial–lateral and rotational stability of knee joint. After ACL ruptures, the instability of the ACL-deficient knee increases mechanical stress on menisci and chondral surfaces, resulting in an increased injury rate of cartilage and meniscus over time after ACL injury [15–19]. In addition, we believe that the osteophyte of the intercondylar notch will develop in order to provide secondary stabilization with elongated course of ACL rupture [20], eventually leading to significant secondary notch stenosis over 5 years after ACL rupture.
Functional outcome of osteochondral autograft is equivalent in stable knee and in anterior cruciate ligament reconstruction
2021, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :Lesions are usually isolated, on stable knee without associated ligament injury. However, in up to 10% or 20% of cases, traumatic cartilage damage is associated with anterior cruciate ligament (ACL) tear [14–18]. The initial cartilage lesion may impair clinical results [19].
Functional outcome of osteochondral autograft is equivalent in stable knee and in anterior cruciate ligament reconstruction
2021, Revue de Chirurgie Orthopedique et TraumatologiqueJapanese Orthopaedic Association (JOA) clinical practice guidelines on the management of anterior cruciate ligament injury – Secondary publication
2020, Journal of Orthopaedic ScienceCitation Excerpt :Conversely, the average interval between injury and surgery in patients with cartilage injury was significantly longer (37 months) than that in patients without cartilage injury. The authors also showed that the longer the interval between injury and surgery, the worse the articular cartilage conditions [100]. The meta-analysis reported in this guideline also supports early (within 3 months after injury) ACL reconstruction from the standpoint of preventing articular cartilage injury (Fig. 4) [92–95,97,101].