MENISCAL INJURY IN ISOLATED ANTERIOR CRUC IATE LIGAMENT INSUFFICIENCY

In this retrospective study the meniscal status of 34 patients with un treated complete anterior cruciate ligament (ACL) tears is reported. T he anterior cruciate ligament injury was initially documented by exami nation under anesthesia and arthroscopy. Treatment in all cases consis ted of a standard protocol of early rehabilitation and bracing. The me an follow-up was 7.3 years. Twenty-two (65%) patients showed signs of meniscal pathology at an average of 2.5 years after the ACL injury dur ing the follow-up period. Rearthroscopy was performed and showed a hig her incidence of medial meniscus tears (53%) than lesions of the later al meniscus (41%). The most common tear of the medial meniscus was the bucket-handle type, followed by the flap tear and the single longitud inal split of the posterior horn. Secondary reconstruction of the ACL was necessary in 18 patients (82%) complaining of symptoms indicative of permanent anterior instability of the knee. The remaining 4 patient s had rearthroscopy 3.5 years after the ACL injury and a partial menis cectomy and ACL reconstruction was performed. 12 patients (35%) had no symptoms or signs of joint instability or meniscal pathology during t he follow-up period, but discontinued their sporting activities. This study indicates the increasing incidence of meniscal tears during ACL insufficiency. We recommend that patients with ruptures of the anterio r cruciate ligament should be investigated for meniscal tears and that early ligament reconstruction of the knee and meniscal repair or part ial meniscectomy should be considered simultaneously.