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The Effects of Time Course After Anterior Cruciate Ligament Injury in Correlation with Meniscal and Cartilage Loss

George A. C. Murrell, MBBS, DPhil^*,,, Sirish Maddali, MD^*, Lois Horovitz, RN^*, Stephen P. Oakley, FRACP and Russell F. Warren, MD^*

Departments of Orthopaedic Surgery, St. George Hospital Campus, University of New South Wales, Sydney, Australia
Rheumatology, St. George Hospital Campus, University of New South Wales, Sydney, Australia
^* The Hospital for Special Surgery, affiliated with Cornell University Medical College, New York, New York

Address correspondence and reprint requests to George A. C. Murrell, MBBS, DPhil, Department of Orthopaedic Surgery, St. George Hospital, Sydney 2217, Australia

In this study, 130 consecutive patients with anterior cruciate ligament insufficiency who were undergoing ligament reconstruction underwent arthroscopic examination at the time of reconstruction, and any loss of meniscal or chondral integrity was documented in a systematic fashion. In these patients, a greater proportion of the medial meniscus was lost compared with the lateral meniscus (16% versus 5%). On average, 6 cm² of the articular cartilage was damaged (5.2 cm²) or lost (0.8 cm²), with the area of damage and loss greatest on the medial femoral condyle. Patients whose injuries had occurred more than 2 years before the examination had more than sixfold greater cartilage loss and damage compared with those whose injuries had occurred within the past 2 months. Meniscal loss was associated with a threefold increase in cartilage damage or loss. The group of patients with meniscal loss whose initial anterior cruciate ligament injury occurred more than 2 years before examination exhibited 18 times the amount of cartilage loss or damage as did the group that had no meniscal loss and whose injury occurred less than 1 month before examination.

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