Association Between Previous Meniscal Surgery and the Incidence of Chondral Lesions at Revision Anterior Cruciate Ligament Reconstruction
Authors: Brophy Robert H. , Wright Rick W. , David Tal S. , McCormack Robert G. , Sekiya Jon K. , Svoboda Steven J. , Huston Laura J. , Haas Amanda K. , Steger-May Karen ,   for the Multicenter ACL Revision Study (MARS) Group, 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 , Brockmeier Stephen F. , Bush-Joseph Charles A. , Butler 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. , DeBerardino Thomas M. , Dunn Warren R. , Flanigan David C. , Frederick Robert W. , Ganley Theodore J. , 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 Christopher 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. , 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 , Shea Kevin G. , Sherman Orrin H. , Slauterbeck James R. , Smith Matthew V. , Spang Jeffrey T. , Spindler Kurt P. , Stuart Michael 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: February 2012

Background: Knees undergoing revision anterior cruciate ligament (ACL) reconstruction typically have more intra-articular injuries than do knees undergoing primary reconstruction. Hypothesis: Previous partial meniscectomy (PM) is associated with a higher rate of chondral lesions at revision ACL reconstruction, whereas previous meniscal repair (MR) is not associated with a higher rate of chondral lesions at revision ACL reconstruction, compared with knees undergoing revision ACL with no previous meniscal surgery. Study design: Cohort study (Prevalence); Level of evidence, 2. Methods: Data from a multicenter cohort was reviewed to determine the history of prior meniscal surgery (PM/MR) and the presence of grade II/III/IV chondral lesions at revision ACL reconstruction. The association between previous meniscal surgery and the incidence of chondral lesions was examined. Patient age was included as a covariate to determine if surgery type contributes predictive information independent of patient age. Results: The cohort included 725 ACL revision surgeries. Chondrosis was associated with patient age ( P < .0001) and previous meniscal surgery ( P < .0001). After adjusting for patient age, knees with previous PM were more likely to have chondrosis than knees with previous MR ( P = .003) or no previous meniscal surgery ( P < .0001). There was no difference between knees without previous meniscal surgery and knees with previous MR ( P = .7). Previous partial meniscectomy was associated with a higher rate of chondrosis in the same compartment compared with knees without previous meniscal surgery ( P < .0001) and knees with previous MR ( P ≤ .03). Conclusion: The status of articular cartilage at the time of revision ACL reconstruction relates to previous meniscal surgery independent of the effect of patient age. Previous partial meniscectomy is associated with a higher incidence of articular cartilage lesions, whereas previous meniscal repair is not. Although this association may reflect underlying differences in the knee at the time of prior surgery, it does suggest that meniscal repair is preferable when possible at the time of ACL reconstruction.