Description
Purpose: The incidence of meniscal injuries is different according to surgical delay in ACL injuries, the incidence of meniscal tears may increase due to the abnormal kinematics resulting from ACL insufficiency. This study was designed to analyze the prevalence and geographic mapping of meniscal tears in ACL injuries according to injury duration.
Methods: A total of 201 patients who underwent primary ACL reconstruction were included in this study from July 2015 to January 2023. Posteromedial and posterolateral joint space were evaluated in all patients via intercondylar notch view or the posteromedial or posterolateral portal for confirmation of the menisco-capsular junctional tear. Arthroscopic findings and surgical records were reviewed retrospectively. All meniscal injuries were documented on anatomic maps using the Cooper’s classification system. Radial and longitudinal component of meniscal tears was divided and analyzed. The patients who underwent ACL reconstruction were divided according to surgical delay time, into 3 groups, it was as follow; within 6 weeks (Group1), from 6 weeks to 6 months (Group1), and after 6 months (Group3). Each meniscal tear site and incidence was analyzed among the groups.
Results: Patients in group 1 were more likely to have a medial Ramp lesion and lateral menisco-capsular junctional tear than those in group 2 (42.4% compared with 23.1%; p=0.064 and 40.3% compared with 19.2%; p=0.041). Patients who underwent surgery more than 6 months after injury were more likely to have a medial ramp lesion (52.8% compared with 23.1%, p=0.019) and less likely to have lateral menisco-capsular junctional tear (13.9% compared with 19.2%, p= 0.573) compared with Group 2. The incidence of medial bucket handle tear was increased in group 3 with statistically significance compared with Group 1 and 2 (22.2% compared with 2.9% and 0%, p<0.001 and p=0.016) most of medial bucket handle tears were extended from zone A0 and A1 to B 1 and B2.
Conclusion: The injury time over 6month, the incidence of medial Ramp lesion was increased, it was advanced to bucket handle tear. Considering the incidence of meniscal tear based on surgical delay, medial ramp lesions should be considered for repair more aggressively compared to lateral menisco-capsular junctional tear.
