Association of Meniscal Status, Lower Extremity Alignment, and Body Mass Index With Chondrosis at Revision Anterior Cruciate Ligament Reconstruction
Authors: Brophy Robert H. , Haas Amanda K. , Huston Laura J. , Nwosu Samuel K. ,   MARS Group, Wright Rick W. , Harris David C. , Patel Kushal , Pearson David , Schutzman Jake , Tarabichi Majd , Ying David , Albright John P. , Allen Christina R. , Amendola Annunziato , Anderson Allen F. , Andrish Jack T. , Annunziata Christopher C. , Arciero Robert A. , Bach Bernard R. , Baker Champ L. , Bartolozzi Arthur R. , Baumgarten Keith M. , Bechler Jeffery R. , Berg Jeffrey H. , Bernas Geoffrey A. , Brockmeier Stephen F. , Bush-Joseph Charles A. , Butler V J. Brad , Campbell John D. , Carey James L. , Carpenter James E. , Cole Brian J. , Cooper Daniel E. , Cooper Jonathan M. , Cox Charles L. , Creighton R. Alexander , Dahm Diane L. , David Tal S. , DeBerardino Thomas M. , Dunn Warren R. , Flanigan David C. , Frederick Robert W. , Ganley Theodore J. , Garafoli Elizabeth A. , Gatt Charles J. , Gecha Steven R. , Giffin James Robert , Hame Sharon L. , Hannafin Jo A. , Harner Christopher D. , Harris Norman Lindsay , Hechtman Keith S. , Hershman Elliott B. , Hoellrich Rudolf G. , Hosea Timothy M. , Johnson David C. , Johnson Timothy S. , Jones Morgan H. , Kaeding hristopher C. , Kamath Ganesh V. , Klootwyk Thomas E. , Lantz Brett (Brick) A. , Levy Bruce A. , Ma C. Benjamin , Maiers G. Peter , Mann Barton , Marx Robert G. , Matava Matthew J. , Mathien Gregory M. , McAllister David R. , McCarty Eric C. , McCormack Robert G. , Miller Bruce S. , Nissen Carl W. , O’Neill Daniel F. , Owens Brett D. , Parker Richard D. , Purnell Mark L. , Ramappa Arun J. , Rauh Michael A. , Rettig Arthur C. , Sekiya Jon K. , Shea Kevin G. , Sherman Orrin H. , Slauterbeck James R. , Smith Matthew V. , Spang Jeffrey T. , Spindler Kurt P. , Stuart Michael J. , Svoboda Steven J. , Taft Timothy N. , Tenuta Joachim J. , Tingstad Edwin M. , Vidal Armando F. , Viskontas Darius G. , White Richard A. , Williams James S. , Wolcott Michelle L. , Wolf Brian R. , York James J. 
Published: April 2015

Background:

Knees undergoing revision anterior cruciate ligament reconstruction (rACLR) have a high prevalence of articular cartilage lesions.

Hypothesis:

The prevalence of chondrosis at the time of rACLR is associated with meniscal status and lower extremity alignment.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Data from the prospective Multicenter ACL Revision Study (MARS) cohort were reviewed to identify patients with preoperative lower extremity alignment films. Lower extremity alignment was defined by the weightbearing line (WBL) as a percentage of the tibial plateau width, while the chondral and meniscal status of each weightbearing compartment was recorded at the time of surgery. Multivariable proportional odds models were constructed and adjusted for relevant factors to examine which risk factors were independently associated with the degree of medial and lateral compartment chondrosis.

Results:

The cohort included 246 patients with lower extremity alignment films at the time of rACLR. Mean (±SD) patient age was 26.9 ± 9.5 years and body mass index (BMI) was 26.4 ± 4.6. The medial compartment had more chondrosis (grade 2/3, 42%; grade 4, 6.5%) than did the lateral compartment (grade 2/3, 26%; grade 4, 6.5%). Disruption of the meniscus was noted in 35% of patients on the medial side and 16% in the lateral side. The mean WBL was 0.43 ± 0.13. Medial compartment chondrosis was associated with BMI ( P = .025), alignment ( P = .002), and medial meniscal status ( P = .001). None of the knees with the WBL lateral to 0.625 had grade 4 chondrosis in the medial compartment. Lateral compartment chondrosis was significantly associated with age ( P = .013) and lateral meniscal status ( P < .001). Subjects with “intact” menisci were found to decrease their odds of having chondrosis by 64% to 84%.

Conclusion:

The status of articular cartilage in the tibiofemoral compartments at the time of rACLR is related to meniscal status. Lower extremity alignment and BMI are associated with medial compartment chondrosis.