Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older
Introduction No widely accepted evidence-based indications exist for the initial surgical management of patients with anterior cruciate ligament (ACL) injuries ≥ 40 years old, and treatment for these patients remains controversial. This study aimed to evaluate the association between elapsed time fr...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2021-06, Vol.141 (6), p.971-975 |
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| creator | Kawashima, Itaru Tsukahara, Takashi Sakai, Tadahiro Kawai, Ryosuke Ishizuka, Shinya Hiraiwa, Hideki Imagama, Shiro |
| description | Introduction
No widely accepted evidence-based indications exist for the initial surgical management of patients with anterior cruciate ligament (ACL) injuries ≥ 40 years old, and treatment for these patients remains controversial. This study aimed to evaluate the association between elapsed time from ACL injury to surgery and the incidence of meniscal tears and chondral injury in patients aged ≥ 40 years.
Materials and methods
The patients who underwent primary ACL reconstruction were divided into two groups based on elapsed time from injury to surgery: early group, |
| doi_str_mv | 10.1007/s00402-020-03745-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2476850547</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2530263393</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-10d3f705265a64f84cde2cac44e26fef4b6c4ce9d25967b10e80c3a13cd206533</originalsourceid><addsrcrecordid>eNp9UUtuFDEQtRCIDIELsECW2GTTUP60u3uJQvhIkdjA2vLY1TMeuu3Bdi_mNrkJUk6GJ5MEiQWrsqvep-xHyGsG7xhA9z4DSOANcGhAdLJt5BOyYlLIRgxMPSUrGIRqemjZGXmR8w6A8X6A5-RMCMmVgm5Ffn_EyRzQURMKJh8TtWmx3hSkk9-YGUOhCW0MudR-8TFQH2xCkzHTssXjzTsMFmkc6YzOm6mW4LOth_Vif2KhWxPchLSgSbkauQecjfPepHJnYrcxuFSbPuyW5Ku6D3Rviq_DStqgu72RcHtzeBSJk8P0kjwbzZTx1X09Jz8-XX2__NJcf_v89fLDdWOlZKVh4MTYQctVa5Qce2kdcmvqELkacZRrZaXFwfF2UN2aAfZghWHCOg6qFeKcXJx09yn-WjAXPdcn4jSZgHHJmstO9S20sqvQt_9Ad3FJoW6neSuAKyGGoyA_oWyKOScc9T752aSDZqCP8epTvLrGq-_i1bKS3txLL-v6h4-UhzwrQJwAuY7CBtNf7__I_gFT5bXE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2530263393</pqid></control><display><type>article</type><title>Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older</title><source>SpringerLink Journals - AutoHoldings</source><creator>Kawashima, Itaru ; Tsukahara, Takashi ; Sakai, Tadahiro ; Kawai, Ryosuke ; Ishizuka, Shinya ; Hiraiwa, Hideki ; Imagama, Shiro</creator><creatorcontrib>Kawashima, Itaru ; Tsukahara, Takashi ; Sakai, Tadahiro ; Kawai, Ryosuke ; Ishizuka, Shinya ; Hiraiwa, Hideki ; Imagama, Shiro</creatorcontrib><description>Introduction
No widely accepted evidence-based indications exist for the initial surgical management of patients with anterior cruciate ligament (ACL) injuries ≥ 40 years old, and treatment for these patients remains controversial. This study aimed to evaluate the association between elapsed time from ACL injury to surgery and the incidence of meniscal tears and chondral injury in patients aged ≥ 40 years.
Materials and methods
The patients who underwent primary ACL reconstruction were divided into two groups based on elapsed time from injury to surgery: early group, < 12 months; and delayed group, ≥ 12 months. Patient records were reviewed for incidence and types of meniscal tears and chondral injuries in each group. Chondral injury grades were evaluated with International Cartilage Regeneration and Joint Preservation Society (ICRS) Criteria.
Results
This study evaluated 67 knees in the early group and 33 knees in the delayed group. Mean ages in each group were 46.9 ± 6.5 and 46.9 ± 6.0. The delayed group showed significantly higher rates of medial meniscal tear [31 of 33, 93.9% vs 29 of 67, 43.3%;
P
< 0.0001; odds ratio (OR), 20.31; 95% confidence interval (CI), 4.49–91.9], medial femoral condyle chondral injuries ≥ ICRS grade II (15 of 33, 45.5% vs 8 of 67, 11.9%;
P
< 0.001; OR, 6.15; 95% CI 2.24–16.83), and medial tibial chondral injuries ≥ ICRS grade II (7 of 33, 21.2% vs 3 of 67, 4.5%;
P
< 0.05; OR, 5.74; 95% CI 1.38–23.9) compared with the early group. With respect to types of medial meniscal tear, the delayed group showed a significantly higher frequency of bucket handle tears (11 of 33, 33.3%) compared with the early group (2 of 67, 3.0%;
P
< 0.0001; OR, 16.25; 95% CI 3.34–79.1).
Conclusions
Delayed ACL reconstruction was associated with increased incidence of chondral injuries and medial meniscal tears, particularly bucket handle tears in this cohort.
Level of evidence
Level III.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03745-4</identifier><identifier>PMID: 33426607</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age groups ; Arthroscopy and Sports Medicine ; Cartilage ; Hospitals ; Knee ; Ligaments ; Medicine ; Medicine & Public Health ; Orthopedics ; Patients ; Sports injuries ; Surgery ; Trauma</subject><ispartof>Archives of orthopaedic and trauma surgery, 2021-06, Vol.141 (6), p.971-975</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-10d3f705265a64f84cde2cac44e26fef4b6c4ce9d25967b10e80c3a13cd206533</citedby><cites>FETCH-LOGICAL-c441t-10d3f705265a64f84cde2cac44e26fef4b6c4ce9d25967b10e80c3a13cd206533</cites><orcidid>0000-0002-0283-6747</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03745-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03745-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33426607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawashima, Itaru</creatorcontrib><creatorcontrib>Tsukahara, Takashi</creatorcontrib><creatorcontrib>Sakai, Tadahiro</creatorcontrib><creatorcontrib>Kawai, Ryosuke</creatorcontrib><creatorcontrib>Ishizuka, Shinya</creatorcontrib><creatorcontrib>Hiraiwa, Hideki</creatorcontrib><creatorcontrib>Imagama, Shiro</creatorcontrib><title>Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
No widely accepted evidence-based indications exist for the initial surgical management of patients with anterior cruciate ligament (ACL) injuries ≥ 40 years old, and treatment for these patients remains controversial. This study aimed to evaluate the association between elapsed time from ACL injury to surgery and the incidence of meniscal tears and chondral injury in patients aged ≥ 40 years.
Materials and methods
The patients who underwent primary ACL reconstruction were divided into two groups based on elapsed time from injury to surgery: early group, < 12 months; and delayed group, ≥ 12 months. Patient records were reviewed for incidence and types of meniscal tears and chondral injuries in each group. Chondral injury grades were evaluated with International Cartilage Regeneration and Joint Preservation Society (ICRS) Criteria.
Results
This study evaluated 67 knees in the early group and 33 knees in the delayed group. Mean ages in each group were 46.9 ± 6.5 and 46.9 ± 6.0. The delayed group showed significantly higher rates of medial meniscal tear [31 of 33, 93.9% vs 29 of 67, 43.3%;
P
< 0.0001; odds ratio (OR), 20.31; 95% confidence interval (CI), 4.49–91.9], medial femoral condyle chondral injuries ≥ ICRS grade II (15 of 33, 45.5% vs 8 of 67, 11.9%;
P
< 0.001; OR, 6.15; 95% CI 2.24–16.83), and medial tibial chondral injuries ≥ ICRS grade II (7 of 33, 21.2% vs 3 of 67, 4.5%;
P
< 0.05; OR, 5.74; 95% CI 1.38–23.9) compared with the early group. With respect to types of medial meniscal tear, the delayed group showed a significantly higher frequency of bucket handle tears (11 of 33, 33.3%) compared with the early group (2 of 67, 3.0%;
P
< 0.0001; OR, 16.25; 95% CI 3.34–79.1).
Conclusions
Delayed ACL reconstruction was associated with increased incidence of chondral injuries and medial meniscal tears, particularly bucket handle tears in this cohort.
Level of evidence
Level III.</description><subject>Age groups</subject><subject>Arthroscopy and Sports Medicine</subject><subject>Cartilage</subject><subject>Hospitals</subject><subject>Knee</subject><subject>Ligaments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Sports injuries</subject><subject>Surgery</subject><subject>Trauma</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9UUtuFDEQtRCIDIELsECW2GTTUP60u3uJQvhIkdjA2vLY1TMeuu3Bdi_mNrkJUk6GJ5MEiQWrsqvep-xHyGsG7xhA9z4DSOANcGhAdLJt5BOyYlLIRgxMPSUrGIRqemjZGXmR8w6A8X6A5-RMCMmVgm5Ffn_EyRzQURMKJh8TtWmx3hSkk9-YGUOhCW0MudR-8TFQH2xCkzHTssXjzTsMFmkc6YzOm6mW4LOth_Vif2KhWxPchLSgSbkauQecjfPepHJnYrcxuFSbPuyW5Ku6D3Rviq_DStqgu72RcHtzeBSJk8P0kjwbzZTx1X09Jz8-XX2__NJcf_v89fLDdWOlZKVh4MTYQctVa5Qce2kdcmvqELkacZRrZaXFwfF2UN2aAfZghWHCOg6qFeKcXJx09yn-WjAXPdcn4jSZgHHJmstO9S20sqvQt_9Ad3FJoW6neSuAKyGGoyA_oWyKOScc9T752aSDZqCP8epTvLrGq-_i1bKS3txLL-v6h4-UhzwrQJwAuY7CBtNf7__I_gFT5bXE</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Kawashima, Itaru</creator><creator>Tsukahara, Takashi</creator><creator>Sakai, Tadahiro</creator><creator>Kawai, Ryosuke</creator><creator>Ishizuka, Shinya</creator><creator>Hiraiwa, Hideki</creator><creator>Imagama, Shiro</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0283-6747</orcidid></search><sort><creationdate>20210601</creationdate><title>Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older</title><author>Kawashima, Itaru ; Tsukahara, Takashi ; Sakai, Tadahiro ; Kawai, Ryosuke ; Ishizuka, Shinya ; Hiraiwa, Hideki ; Imagama, Shiro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-10d3f705265a64f84cde2cac44e26fef4b6c4ce9d25967b10e80c3a13cd206533</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age groups</topic><topic>Arthroscopy and Sports Medicine</topic><topic>Cartilage</topic><topic>Hospitals</topic><topic>Knee</topic><topic>Ligaments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Sports injuries</topic><topic>Surgery</topic><topic>Trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawashima, Itaru</creatorcontrib><creatorcontrib>Tsukahara, Takashi</creatorcontrib><creatorcontrib>Sakai, Tadahiro</creatorcontrib><creatorcontrib>Kawai, Ryosuke</creatorcontrib><creatorcontrib>Ishizuka, Shinya</creatorcontrib><creatorcontrib>Hiraiwa, Hideki</creatorcontrib><creatorcontrib>Imagama, Shiro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawashima, Itaru</au><au>Tsukahara, Takashi</au><au>Sakai, Tadahiro</au><au>Kawai, Ryosuke</au><au>Ishizuka, Shinya</au><au>Hiraiwa, Hideki</au><au>Imagama, Shiro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>141</volume><issue>6</issue><spage>971</spage><epage>975</epage><pages>971-975</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
No widely accepted evidence-based indications exist for the initial surgical management of patients with anterior cruciate ligament (ACL) injuries ≥ 40 years old, and treatment for these patients remains controversial. This study aimed to evaluate the association between elapsed time from ACL injury to surgery and the incidence of meniscal tears and chondral injury in patients aged ≥ 40 years.
Materials and methods
The patients who underwent primary ACL reconstruction were divided into two groups based on elapsed time from injury to surgery: early group, < 12 months; and delayed group, ≥ 12 months. Patient records were reviewed for incidence and types of meniscal tears and chondral injuries in each group. Chondral injury grades were evaluated with International Cartilage Regeneration and Joint Preservation Society (ICRS) Criteria.
Results
This study evaluated 67 knees in the early group and 33 knees in the delayed group. Mean ages in each group were 46.9 ± 6.5 and 46.9 ± 6.0. The delayed group showed significantly higher rates of medial meniscal tear [31 of 33, 93.9% vs 29 of 67, 43.3%;
P
< 0.0001; odds ratio (OR), 20.31; 95% confidence interval (CI), 4.49–91.9], medial femoral condyle chondral injuries ≥ ICRS grade II (15 of 33, 45.5% vs 8 of 67, 11.9%;
P
< 0.001; OR, 6.15; 95% CI 2.24–16.83), and medial tibial chondral injuries ≥ ICRS grade II (7 of 33, 21.2% vs 3 of 67, 4.5%;
P
< 0.05; OR, 5.74; 95% CI 1.38–23.9) compared with the early group. With respect to types of medial meniscal tear, the delayed group showed a significantly higher frequency of bucket handle tears (11 of 33, 33.3%) compared with the early group (2 of 67, 3.0%;
P
< 0.0001; OR, 16.25; 95% CI 3.34–79.1).
Conclusions
Delayed ACL reconstruction was associated with increased incidence of chondral injuries and medial meniscal tears, particularly bucket handle tears in this cohort.
Level of evidence
Level III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33426607</pmid><doi>10.1007/s00402-020-03745-4</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-0283-6747</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0936-8051 |
| ispartof | Archives of orthopaedic and trauma surgery, 2021-06, Vol.141 (6), p.971-975 |
| issn | 0936-8051 1434-3916 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2476850547 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Age groups Arthroscopy and Sports Medicine Cartilage Hospitals Knee Ligaments Medicine Medicine & Public Health Orthopedics Patients Sports injuries Surgery Trauma |
| title | Delayed anterior cruciate ligament reconstruction increases the incidence of medial meniscal bucket handle tears and medial compartment chondral injuries in patients aged 40 years and older |
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