Department of Orthopedic Surgery, Joint Reconstruction Research Center, Tehran University of Medical Science, Tehran, Iran.
J Knee Surg. 2022 Aug;35(10):1091-1096. doi: 10.1055/s-0040-1722324. Epub 2021 Feb 22.
The meniscus is one of the most important structures of the knee that needs to be saved if possible. Previous studies showed that increasing time from an anterior cruciate ligament (ACL) injury (TFI) could lead to a meniscal tear, especially medial meniscus (MM). We developed the present study to see if the TFI alone is a predictor of meniscal injury in ACL-deficient knees. We included 111 patients who had a reconstructed ACL injury at our institution from March 2015 to March 2016 in this retrospective cohort study. All demographic data, including age, gender, and body mass index (BMI), were collected. We also recorded the mechanism of injury and the TFI. We extracted the meniscal condition at the time of surgery from the surgical report. All patients were followed up for a mean of 23 months, and the Lysholm score and pain visual analog scale (VAS) score were obtained. The mean TFI of patients with MM tear was 17.4 ± 16.8 months, which was significant than the patients with lateral meniscal (LM) tear (9.3 ± 8.3 months) and intact meniscus (7.4 ± 8.1 months) ( = 0.001). Patients with TFI less than 6 months had a significantly lower rate of MM tear, and increasing TFI more than 6 months could increase the rate of MM tear ( = 0.001). We could not find any association between age, BMI, and gender and meniscal injury. At the latest follow-up, Lysholm and VAS scores in patients with and without meniscal tear were the same. Our study confirms that increasing time from the ACL injury would increase the risk of MM damage. The cutoff point for this risk factor is 6 months from initial injury; therefore, to save the meniscus, it might be better to perform ACL reconstruction within 6 months in ACL-deficient knees.
半月板是膝关节最重要的结构之一，如果可能的话，需要尽可能保留。先前的研究表明，ACL 损伤（TFI）后时间的延长可能导致半月板撕裂，特别是内侧半月板（MM）。我们开展本研究旨在观察 TFI 是否是 ACL 缺失膝关节半月板损伤的预测因素。我们纳入了本机构 2015 年 3 月至 2016 年 3 月期间重建 ACL 损伤的 111 例患者，进行回顾性队列研究。收集所有人口统计学数据，包括年龄、性别和体重指数（BMI）。我们还记录了损伤机制和 TFI。我们从手术报告中提取手术时的半月板情况。所有患者平均随访 23 个月，获得 Lysholm 评分和疼痛视觉模拟评分（VAS）。MM 撕裂患者的 TFI 平均值为 17.4±16.8 个月，明显长于外侧半月板（LM）撕裂（9.3±8.3 个月）和半月板完整（7.4±8.1 个月）患者（=0.001）。TFI 小于 6 个月的患者 MM 撕裂发生率显著较低，TFI 大于 6 个月会增加 MM 撕裂的发生率（=0.001）。我们未发现年龄、BMI 和性别与半月板损伤之间存在任何关联。在末次随访时，有和无半月板撕裂患者的 Lysholm 和 VAS 评分相同。本研究证实，ACL 损伤后时间的延长会增加 MM 损伤的风险。该风险因素的截断点是初始损伤后 6 个月；因此，为了保留半月板，在 ACL 缺失膝关节中，最好在 6 个月内进行 ACL 重建。
