METHODS: Between 2012 and 2022, 1,840 consecutive ACLRs were performed. A total of 1,317 ACLRs were included with a mean patient age of 31.2 years ± 10.5 [16-60]. Meniscal tear was assessed during arthroscopy using the ISAKOS classification. Time from injury to ACLR, Tegner Activity Scale, age, BMI and gender were analysed in uni- and then in multivariate analyses. Patients were divided into four groups according to the time from injury to surgery: < 3 months (427; 32%), 3-6 months (388; 29%), 6-12 months (248; 19%) and > 12 months (254; 19%).
RESULTS: Delaying ACLR > 12 months significantly increased the rate of medial meniscal (MM) injury (OR 1.14; p < 0.001). No correlation was found between a 3- or 6-month time from injury to surgery and MM tear. Performing ACLR > 3, 6, or 12 months after injury did not significantly increase the rate of lateral meniscal (LM) injury. Increasing Tegner activity scale was significantly associated with a lower rate of MM injury (OR 0.90; p = 0.020). An age > 30 years (OR 1.07; p = 0.025) and male gender (OR 1.13; p < 0.0001) was also associated with an increased rate of MM injury. Age > 30 years decreased the rate of MM repair (OR 0.85; p < 0.001). Male gender increased the rate of LM tear (OR 1.10; p = 0.001).
CONCLUSIONS: Performing ACLR more than 12 months after injury was associated with increased rates of MM injury but not with lower rates of repairable lesions. An increased pre-injury Tegner activity score was associated with a decreased rate of MM tear. Age > 30 years was associated with an increased rate of MM tear with concomitant ACL injury and a decreased rate of repairability of MM tear. ACLR should be performed within 12 months from injury to prevent from the risk of MM injury.
METHODS: Level III.
方法:在2012年至2022年之间,进行了1,840次连续的ACLRs。共纳入1,317例ACLRs,患者平均年龄为31.2岁±10.5[16-60]。在关节镜检查期间使用ISAKOS分类评估半月板撕裂。从受伤到ACLR的时间,Tegner活动量表,年龄,BMI和性别分别在单因素分析和多因素分析中进行分析。根据受伤到手术的时间将患者分为四组:<3个月(427;32%),3-6个月(388;29%),6-12个月(248;19%)和>12个月(254;19%)。
结果:延迟ACLR>12个月可显着增加内侧半月板(MM)损伤的发生率(OR1.14;p<0.001)。从损伤到手术的3个月或6个月时间与MM撕裂之间没有发现相关性。损伤后ACLR>3、6或12个月并没有显着增加外侧半月板(LM)损伤的发生率。增加的Tegner活动量表与较低的MM损伤率显着相关(OR0.90;p=0.020)。年龄>30岁(OR1.07;p=0.025)和男性(OR1.13;p<0.0001)也与MM损伤的发生率增加有关。年龄>30岁降低MM修复率(OR0.85;p<0.001)。男性增加LM撕裂率(OR1.10;p=0.001)。
结论:在损伤后超过12个月进行ACLR与MM损伤的发生率增加有关,但与可修复病变的发生率无关。伤前Tegner活动评分增加与MM撕裂率降低相关。年龄>30岁与伴随ACL损伤的MM撕裂率增加和MM撕裂修复率降低相关。ACLR应在受伤后12个月内进行,以防止MM受伤的风险。
方法:三级。