Abstract

Anterior cruciate ligament (ACL) injuries impair quality of life of an athlete with the possibility of osteoarthritis if left untreated. The aims of the study were to analyse the pattern of chondral and meniscal injuries and the temporal association of severity of these injuries with delay in ACL reconstruction.
Material and Methods: In this prospective study, patients who underwent knee arthroscopy from Jan 2015 to Dec 2018 for clinico-radiologically diagnosed ACL tear were included in the study. Mode of injury, time from injury (TFI) to ACL reconstruction and intraoperative findings of chondral lesions, meniscal tears and other intra-articular injuries was recorded. The association between the index injury and whether there was any significant correlation between TFI, severity of chondral and meniscal lesions and mode of injury were analysed.
Results:429 male and 15 female athletes were included in the study with a mean age of 28.98±7.08 years,53.6% of patients in the 26–35 years age group. Twisting during running events was the most common mode of injury in 139(31.3%) patients. MeanTFI was 55.35±23.84(14-129) weeks. There was a significant correlation between the grade of the chondral lesion and TFI (p < 0.0001) as all grade III and IV chondral lesions were observed with a mean TFI of 69.9±4.23 weeks. The odds of finding a medial meniscus tear associated with a complete ACL tear were statistically significant when TFI was more than 59.3 weeks. There was a significant correlation between the incidence of medial compartment chondral injury and medial meniscus tear at a mean TFI of 55.3 weeks(p=0.007,OR=1.90) without significant correlation between lateral compartment chondral injury and lateral meniscus tear (p=0.91, OR=1.03).There was no significant correlation between a particular mode of injury and ACL tear.
Conclusions: The delay in treatment of ACL injuries greater than 70 weeks leads to higher grade chondral lesions and complex meniscal injuries in young athletes that can be avoided with early management of an ACL deficient knee