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Increased time to Surgery after ACL Tear in Females results in Greater Risk of Medial Meniscus Tear

Published:October 26, 2022DOI:https://doi.org/10.1016/j.arthro.2022.10.014

      Abstract

      Purpose

      This study assessed the incidence of meniscal tears in ACL deficient knees considering the time between injury and reconstruction in a large sample of female patients. Furthermore, we evaluated whether the rate of meniscal repair or meniscectomy was affected by age and BMI.

      Methods

      The medical records of 489 patients who underwent ACL reconstructive surgery between January 2011 and April 2021 were analyzed to collect data on the prevalence of meniscal tears, surgical timing, patient age, and BMI. Logistic regression was performed to estimate the association between the prevalence of meniscal tears and the independent variables of surgical timing, age, and BMI.

      Results

      Between 24 and 60 months after their injury, female patients show a statistically significant increase in the presence of associated meniscal lesions when compared to ACL reconstruction performed earlier [OR= of 3.58 (95% CI)] especially for medial meniscal tears with an OR of 1.94 (95% CI 1.23-3.05, p=0.004) between 12 and 24 month. There is a statistically significant difference after 12 months in the rate of meniscal suturing for medial meniscus tears [OR: 3.30 CI 1.37-7.91 p=0.007). Increasing age was associated with a higher prevalence of meniscal tears up to 30-50 years ], but there was no clear association between BMI and associated lesions other than a higher rate of meniscectomies

      Conclusion

      In female patients who experienced an ACL injury, a delay in surgery greater than 12 months is associated with a gradual increase in the risk of non-repairable medial meniscal tear; this risk becomes statistically significant after 24 months. A high BMI does not seem to have relevance in the onset of associated lesions in women but results in a higher rate of meniscectomies compared to meniscal sutures, while age between 30 and 50 is associated with a greater risk of associated injuries.
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