A retrospective analysis of risk factors for meniscal co-morbidities in anterior cruciate ligament injuries

BACKGROUND: The association of meniscal cartilage injury with anterior cruciate ligament (ACL) injury is well documented in literature. The aim of this study was to examine the relative risk factors for meniscal pathology at the time of arthroscopic ACL reconstruction. MATERIALS AND METHODS: A review of the case records including both in-patient and out-patient charts of all patients who underwent arthroscopic ACL reconstruction during the preceding 3 years was performed by either of the authors. The relative incidences of associated meniscal pathologies were analyzed in correlation with age, side of injury, time to surgery, mode of injury, and gender as the risk factors. Statistical analysis was performed to obtain individual data correlation. RESULTS: A total of 192 patients underwent ACL reconstruction during the 3-year time frame. Of these, complete data sets were available for 129 patients. Analysis revealed that the only factor that was statistically significant in raising the risk of meniscal pathology was the time to surgery (P = 0.001). There was a significant increase in medial, lateral, and both meniscal tears noted in cases operated beyond 24 weeks. Further, the incidence of medial meniscal tears as well as lateral meniscal tears increased with delay in presentation for surgery (P = 0.004). Mode of injury, age at presentation, sex, and side were not significantly associated with an increased incidence of meniscal pathology. CONCLUSION: The single factor that significantly affects incidence of meniscal co-morbidity in ACL injury is the delay in presentation (i.e. the time to surgery). The incidence of lateral meniscal tears as well as medial meniscal tears increased with delay in surgery. This should guide us toward recommending all patients irrespective of age, gender, or mode of injury to undergo early reconstruction, thereby reducing the likelihood of developing meniscal pathology.