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Articular and meniscal pathology associated with primary ACL reconstruction

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Purpose: The purpose of this study was to determine the severity and location of meniscal and chondral lesions in patients undergoing ACL reconstruction at variable times from injury to surgery. Methods: The patient demographics, location, grade and number of chondral injuries as well as location and pattern of meniscal injuries at the time of ACL reconstruction was recorded. Patients were divided into three subgroups according to their time from injury to surgery: acute (less than 4 weeks), subacute (4 to 8 weeks) and chronic (8 weeks or more). Results: Patients undergoing surgery more than 8 weeks after surgery had a statistically significant more severe chondral grade in the medial compartment of the knee when compared to those patients that had surgery acutely. A similar observation was not found in the lateral compartment. The medial meniscal tears were likely to be bucket type tears regardless of the chronicity of the injury and in the lateral meniscal tears were more often flap type tears independent of the time interval between injury and surgery. Conclusions: These findings support early reconstruction in an effort to slow the progression of further damage to the knee.

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