Effect of Concomitant Cartilage Lesions on Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction: A Nationwide Cohort Study From Norway and Sweden of 8470 Patients With 5-Year Follow-up

BACKGROUND: The effect of concomitant focal cartilage lesions on patient-reported outcomes after anterior cruciate ligament reconstruction (ACLR) remains to be determined. PURPOSE: To evaluate the effect of concomitant partial-thickness (International Cartilage Repair Society [ICRS] grades 1-2) and full-thickness (ICRS grades 3-4) cartilage lesions on patient-reported outcomes 5 years after ACLR. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: All patients who underwent unilateral primary ACLR registered in the Norwegian and Swedish National Knee Ligament Registries from 2005 to 2008 (n = 15,783) were included in the study. At 5-year follow-up, 8470 (54%) patients completed the Knee injury and Osteoarthritis Outcome Score (KOOS). Multivariable linear regression models were used to estimate the effect of concomitant partial-thickness and full-thickness cartilage lesions on patient-reported outcomes (KOOS) 5 years after ACLR. RESULTS: Compared with no concomitant cartilage lesions, both partial-thickness and full-thickness cartilage lesions were indicators of statistically significant adverse effects on the KOOS in the adjusted regression analysis at 5-year follow-up after ACLR. CONCLUSION: ACL-injured patients with concomitant cartilage lesions reported worse outcomes and less improvement than those without cartilage lesions 5 years after ACLR.