Document Type: RESEARCH PAPER
Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Background: Articular cartilage injuries are a common clinical problem at the time of ACL reconstruction with an incidence rate of 16-46%. Good results of ACL reconstruction combined with the treatment of chondral lesions have been published in some studies.
Method: After statistical analysis 30 patients were selected and divided in 2 groups. TheFfirst group consisted of 15 patients wite isolated ACL tear without any other concomitant injuries and the second group consisted of 15 patients with ACL tear and concomitant high grade (grade 3 or 4 of outerbridge classification) contained articular cartilage injuries during arthroscopy. Group 1 underwent ACL reconstruction and group 2 underwent ACL reconstruction combined with chondroplasty via the drilling and microfracture technique. For each patient the Lysholm knee score questionnaire was completed before surgery, 6 months and 1 year after surgery.
Results: The mean Lysholm knee score in both groups improves: 9.6 points after 6 months and 16.06 points after 1 year in group 1 and 23.26 points after 6 months and 30.66 after 1 year in group 2, whict was statistically significant (Pvalue<0.05).
Conclusion: Improvement in the Lysholm knee score in both groups showed that ACL reconstruction concomitant with high grade chondral injury chondroplasty with microfracture and drilling techniques have good results with patient satisfaction and improves their quality of life.
- Brophy RH, Zelster D, Wright RW, Flanigan D. Anterior cruciate ligament reconstruction and articular cartilage Injury: Incidence and treatment. Arthroscopy. 2010; 26(1):112-20.
- Siegel L, Vandenakker-Albanese C, Siegel D.Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management. Clin J Sport Med. 2012; 22(4):349-55.
- Rahr-Wagner L, Thillemann T, Pedersen A, Lind M. Comparison of hamstring tendon and patellar tendon grafts in anterior cruciate ligament reconstruction in a nationwide population-based cohort study: results from the Danish registery of knee ligament reconstruction. Am J Sports Med. 2013; 42(2):278-84.
- Chen G, Tang X, Li Q, Zheng G, Yang T, Li J. The evaluation of patient-specific factors associated with meniscal and chondral injuries accompanying ACL rupture in young adult patients.Knee Surg Sports Traumatol Arthrosc. 2013;23(2):792-8.
- Shelbourne K, Gray T. Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five to fifteen year evaluations. Am J Sports Med. 2000; 28(4):446-52.
- Takeda T, Matsumoto H, fujikawa K. Influence of secondary damage to menisci and articular cartilage on return to sports after anterior cruciate ligament reconstruction. J Orthop Sci. 1997; 2(4):215-21
- Friemert B, Oberlander Y, Schwarz W, Haberle H, Bahren W, Gerngross H, et al.Diagnosis of chondral lesions of the knee joint: can MRI replace arthroscopy? A prospective study. Knee Surg Sports Traumatol Arthrosc. 2004; 12(1):58-64.
- Dandy DJ. Abrasion chondroplasty. Arthroscopy. 1986; 2(1):51-3.
- Matsusue Y, Yamamuro T, Hama H. Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy. 1993; 9(3):318-21.
- Peterson L, Minas T, Brittberg M, Lindahl A. Treatment of osteochondritis disecans of the knee with autologus chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am. 2003; 85-A Suppl 2:17-24.
- Amin AA, Bartlett W, Gooding CR, Sood M, Skinner JA, Carrington RW, et al. The use of autologus chondrocyte implantation following and combined with anterior cruciate ligament reconstruction. Int Orthop. 2006; 30(1):48-53.
- Gaweda K, Walawski J, Wegłowski R, Patyra M. Rehabilitation after one-stage anterior cruciate reconstruction and osteochondral grafting. Int Orthop. 2006; 30(3):185-9.