PRAGUE — A long-term follow-up of 43 patients who were treated for
ACL tears but untreated for associated knee cartilage lesions showed that the
group did just as well as patients without cartilage lesions who underwent
similar ACL treatments.
Wojciech Widuchowski, MD, and colleagues included patients with
Outerbridge grade 3 and 4 lesions in their investigation conducted from 1991 to
1995. They evaluated lesions with a mean size of 2.6 cm², most of which
were on the medial femoral condyle.
“Our conclusions are these cartilage lesions found during ACL
reconstruction left with no treatment do not appear to affect the clinical
outcome at 10 and 15 year follow-up. Our study seems to reinforce the question
whether treatment of a symptomatic lesion provides improvement over that of the
natural history,” he said in a presentation at the SICOT XXV Triennial
World Congress 2011, here.
Widuchowski noted that applying these findings could represent
significant cost savings for health care systems and possibly reduce the tens
of thousands of knee arthroscopy procedures done annually in the United States
He said the patients were followed up at 10 and 15 years after ACL
surgery using both domains of the IKDC score, the Lysholm score and Tegner
At both follow-up time points, these outcome scores proved similar to
those of a matched group of patients without cartilage lesions who also had ACL
surgery and completed the same postoperative rehabilitation regimen.
Compared to the control group, “At both 10 and 15 years follow-up,
we observed no significant correlation between lesion size and postoperative
scores, lesion location and postoperative scores and lesion grade and
postoperative scores,” Widuchowski said.
- Widuchowski W, Lukasik P, Ryszard F, et al. Untreated deep
cartilage lesions associated with ACL injury: Results at 10 and 15 years
follow-up. Paper #28870. Presented at the SICOT XXV Triennial World Congress
2011. Sept. 6-9. Prague.
- Disclosure: Widuchowski has no relevant financial
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