Meniscus or Cartilage Injury at the Time of Anterior Cruciate Ligament Tear Is Associated With Worse Prognosis for Patient-Reported Outcome 2 to 10 Years After Anterior Cruciate Ligament Injury: A Systematic Review.
Marie Pedersen, Jessica L Johnson, Hege Grindem and 3 others
PMID 32741324WHAT IT FOUND
Patients with ACL tears who also have meniscus or cartilage injuries report worse knee function and quality of life two to ten years after surgery.
These concurrent injuries are a strong predictor of poor long-term outcomes, unlike age or sex which showed no association.
Key findings
01Concomitant meniscus and cartilage injuries were prognostic factors for worse patient-reported outcomes two to ten years after ACL reconstruction.
02The impact of concomitant meniscus injury on sport and recreation function (10-14.4 point difference) was clinically relevant, exceeding the minimal important change.
03Factors such as sex, age, ethnicity, and type of sport were not statistically significant predictors of long-term patient-reported outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most studies included patients undergoing ACL reconstruction, so findings may not apply to those treated with rehabilitation alone. High risk of bias in many included studies, particularly regarding confounding and statistical reporting. The review did not include psychological factors or overall quality of life outcomes, focusing only on knee-specific PROMs and activity levels. Potential overlap of patients across studies from large registries (MOON, SKLR/NKLR) could have influenced results.
Declared interests
The authors declared no financial affiliation or involvement with commercial organizations.
The easy way to misread this
Do not assume these prognostic factors apply equally to patients treated with rehabilitation alone, as the evidence for that group was very low and derived from a single study. The strong negative association with meniscus and cartilage injury is specific to patients undergoing ACL reconstruction.