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Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns.

Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Südkamp NP, Niemeyer P - J Orthop Surg Res (2015)

Bottom Line: A database of 268 patients undergoing primary ACL reconstruction was used to identify all patients with isolated ACL tears and patients with an associated tear of the lateral meniscus.Of those, 56% had isolated ACL tears, 27% had associated minor tears, and 17% had associated major tears of the lateral meniscus.Special attention is therefore necessary in those patients and early referral to magnetic resonance imaging and/or arthroscopy is recommended to allow meniscus repair in a timely manner.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany. matthias.feucht@gmx.net.

ABSTRACT

Background: The pattern of lateral meniscus tears observed in anterior cruciate ligament (ACL)-injured subjects varies greatly and determines subsequent management. Certain tear patterns with major biomechanical consequences should be repaired in a timely manner. Knowledge about risk factors for such tears may help to identify patients in the early posttraumatic phase and subsequently may improve clinical results.

Methods: A database of 268 patients undergoing primary ACL reconstruction was used to identify all patients with isolated ACL tears and patients with an associated tear of the lateral meniscus. Patients who underwent surgery >6 months after the injury were excluded. Based on the arthroscopic appearance of the lateral meniscus, patients were assorted to one of three groups: 'no tear,' 'minor tear,' and 'major tear.' Tear patterns defined as major included root tears, complete radial tears, and unstable longitudinal tears including bucket-handle tears. Univariate analysis was performed by comparing the three groups with regard to gender, age, height, weight, BMI, type of injury (high-impact sport, low-impact sport, and not sports related), and mechanism of injury (non-contact vs. contact). Multivariate logistic regression was carried out to identify independent risk factors for minor and major meniscal tears and to calculate odds ratios (OR).

Results: Two hundred fifteen patients met the inclusion and exclusion criteria. Of those, 56% had isolated ACL tears, 27% had associated minor tears, and 17% had associated major tears of the lateral meniscus. Univariate analysis revealed significant differences between the three groups for gender (p = 0.002), age groups (p = 0.026), and mechanism of injury (p < 0.001). A contact injury mechanism was a risk factor for minor tears (OR: 4.28) and major tears (OR: 18.49). Additional risk factors for major tears were male gender (OR: 7.38) and age <30 years (OR: 5.85).

Conclusion: Male patients, patients <30 years, and particularly patients who sustained a contact injury have a high risk for an associated major lateral meniscus tear. Special attention is therefore necessary in those patients and early referral to magnetic resonance imaging and/or arthroscopy is recommended to allow meniscus repair in a timely manner.

No MeSH data available.


Related in: MedlinePlus

Significant results. Distribution of gender (A), age groups (B), and injury mechanism (C) within each group. The sole independent risk factor for a minor tear was a contact mechanism. Independent risk factors for major tears were male gender, age <30 years, and a contact mechanism.
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Fig2: Significant results. Distribution of gender (A), age groups (B), and injury mechanism (C) within each group. The sole independent risk factor for a minor tear was a contact mechanism. Independent risk factors for major tears were male gender, age <30 years, and a contact mechanism.

Mentions: Of the 215 included patients, 120 (56%) patients had isolated ACL tears, 58 (27%) had an associated minor lateral meniscus tear, and 37 (17%) had an associated major lateral meniscus tear. The detailed distribution of meniscus tear patterns is shown in Table 1. Patient characteristics of each group and the results of the univariate group comparison are presented in Table 2. Statistically significant differences between the ‘no tear’ and ‘minor tear’ groups were found for the mechanism of injury, with a higher proportion of contact injuries in the minor tear group (p = 0.006). Compared to patients with no tear, a significantly higher proportion of male patients (p < 0.001), patients <30 years (p = 0.015), and contact injuries (p < 0.001) were found in patients with major tears. In addition, contact injuries were significantly more common in patients with major tears as compared to patients with minor tears (p = 0.009). The results of the multivariate logistic regression analysis are shown in Table 3. The sole independent risk factor for a minor tear was a contact mechanism with an OR of 4.28 (95% CI, 1.74–10.56). Independent risk factors for major tears were male gender (OR, 7.38; 95% CI, 1.97–27.61), age <30 years (OR, 5.85; 95% CI, 1.71–19.94), and a contact mechanism (OR, 18.49; 95% CI, 5.96–57.37) (Figure 2).Table 1


Associated tears of the lateral meniscus in anterior cruciate ligament injuries: risk factors for different tear patterns.

Feucht MJ, Bigdon S, Bode G, Salzmann GM, Dovi-Akue D, Südkamp NP, Niemeyer P - J Orthop Surg Res (2015)

Significant results. Distribution of gender (A), age groups (B), and injury mechanism (C) within each group. The sole independent risk factor for a minor tear was a contact mechanism. Independent risk factors for major tears were male gender, age <30 years, and a contact mechanism.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389969&req=5

Fig2: Significant results. Distribution of gender (A), age groups (B), and injury mechanism (C) within each group. The sole independent risk factor for a minor tear was a contact mechanism. Independent risk factors for major tears were male gender, age <30 years, and a contact mechanism.
Mentions: Of the 215 included patients, 120 (56%) patients had isolated ACL tears, 58 (27%) had an associated minor lateral meniscus tear, and 37 (17%) had an associated major lateral meniscus tear. The detailed distribution of meniscus tear patterns is shown in Table 1. Patient characteristics of each group and the results of the univariate group comparison are presented in Table 2. Statistically significant differences between the ‘no tear’ and ‘minor tear’ groups were found for the mechanism of injury, with a higher proportion of contact injuries in the minor tear group (p = 0.006). Compared to patients with no tear, a significantly higher proportion of male patients (p < 0.001), patients <30 years (p = 0.015), and contact injuries (p < 0.001) were found in patients with major tears. In addition, contact injuries were significantly more common in patients with major tears as compared to patients with minor tears (p = 0.009). The results of the multivariate logistic regression analysis are shown in Table 3. The sole independent risk factor for a minor tear was a contact mechanism with an OR of 4.28 (95% CI, 1.74–10.56). Independent risk factors for major tears were male gender (OR, 7.38; 95% CI, 1.97–27.61), age <30 years (OR, 5.85; 95% CI, 1.71–19.94), and a contact mechanism (OR, 18.49; 95% CI, 5.96–57.37) (Figure 2).Table 1

Bottom Line: A database of 268 patients undergoing primary ACL reconstruction was used to identify all patients with isolated ACL tears and patients with an associated tear of the lateral meniscus.Of those, 56% had isolated ACL tears, 27% had associated minor tears, and 17% had associated major tears of the lateral meniscus.Special attention is therefore necessary in those patients and early referral to magnetic resonance imaging and/or arthroscopy is recommended to allow meniscus repair in a timely manner.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery and Traumatology, Freiburg University Hospital, Albert Ludwigs University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany. matthias.feucht@gmx.net.

ABSTRACT

Background: The pattern of lateral meniscus tears observed in anterior cruciate ligament (ACL)-injured subjects varies greatly and determines subsequent management. Certain tear patterns with major biomechanical consequences should be repaired in a timely manner. Knowledge about risk factors for such tears may help to identify patients in the early posttraumatic phase and subsequently may improve clinical results.

Methods: A database of 268 patients undergoing primary ACL reconstruction was used to identify all patients with isolated ACL tears and patients with an associated tear of the lateral meniscus. Patients who underwent surgery >6 months after the injury were excluded. Based on the arthroscopic appearance of the lateral meniscus, patients were assorted to one of three groups: 'no tear,' 'minor tear,' and 'major tear.' Tear patterns defined as major included root tears, complete radial tears, and unstable longitudinal tears including bucket-handle tears. Univariate analysis was performed by comparing the three groups with regard to gender, age, height, weight, BMI, type of injury (high-impact sport, low-impact sport, and not sports related), and mechanism of injury (non-contact vs. contact). Multivariate logistic regression was carried out to identify independent risk factors for minor and major meniscal tears and to calculate odds ratios (OR).

Results: Two hundred fifteen patients met the inclusion and exclusion criteria. Of those, 56% had isolated ACL tears, 27% had associated minor tears, and 17% had associated major tears of the lateral meniscus. Univariate analysis revealed significant differences between the three groups for gender (p = 0.002), age groups (p = 0.026), and mechanism of injury (p < 0.001). A contact injury mechanism was a risk factor for minor tears (OR: 4.28) and major tears (OR: 18.49). Additional risk factors for major tears were male gender (OR: 7.38) and age <30 years (OR: 5.85).

Conclusion: Male patients, patients <30 years, and particularly patients who sustained a contact injury have a high risk for an associated major lateral meniscus tear. Special attention is therefore necessary in those patients and early referral to magnetic resonance imaging and/or arthroscopy is recommended to allow meniscus repair in a timely manner.

No MeSH data available.


Related in: MedlinePlus