Abstract
Background:
Anterior cruciate ligament (ACL) tears are a common injury in athletes. ACL tears often occur with other injuries, including cartilaginous injuries. There is a lack of research regarding cartilage treatment on return to sport (RTS) following ACL reconstruction.
Purpose:
To evaluate the impact of meniscus and/or cartilage (meniscus-cartilage) treatment on return to sport (RTS) rates and time to return to sport following ACL reconstruction with hamstring tendon (HT), patellar tendon (BPTB), and quadriceps tendon (QT) grafts.
Methods:
Competitive and recreational athletes between the ages of 13-24 who had an ACL reconstruction between 2010-2022 were included. Activity level, sport, graft type, cartilage treatment, RTS testing result data, and time to RTS were collected. Chi-square statistics and Wilcoxon rank sum tests were used, and statistical significance was set to p<0.05.
Results:
There were 855 total patients with 354 HT, 361 BPTB, and 140 QT grafts of which 275 did not have meniscus-cartilage treatment and 580 received meniscus-cartilage treatment. Females comprised 52% of ACL reconstructions without meniscus-cartilage treatment and 42% of ACL reconstructions with meniscus-cartilage treatment. The median age was 18 and 17 for those receiving meniscus-cartilage treatment and those without treatment, respectively. Median time to RTS was 27.86 weeks for 151 patients without meniscus-cartilage treatment and 30.49 weeks for 299 patients receiving meniscus cartilage-treatment (p=0.0253). The median 6-meter timed hop ratio was 1.01 for 21 athletes with meniscus-cartilage treatment and 0.965 for 12 athletes without meniscus-cartilage treatment (p=0.0492). Median isokinetic quadriceps testing at 300 degrees per second was 85% of the contralateral leg for 170 athletes with meniscus-cartilage treatment and 85% for 67 athletes without meniscus-cartilage treatment (p=0.7181). Return to previous level of play occurred in 91/104 (87.5%) of those without meniscus-cartilage treatment and 196/220 (89%) of those with meniscus-cartilage treatment (p=0.6742). ACL and non-ACL reinjuries occurred in 18% (49/272) of those without and 20% (118/577) of those with meniscus-cartilage treatment (p=0.4047).
Conclusions:
Time to clearance to return to sport occurred more quickly in those without meniscus-cartilage treatment. Six-meter timed hop testing results were superior in those receiving meniscus-cartilage treatment. This study will aid orthopaedic surgeons and their athletes while addressing common concomitant injuries during ACL reconstruction.