Evaluación artroscópica de cartílago articular posterior a reconstrucción.(In.)

La evaluación artroscópica del cartílago articular después de la reconstrucción del ligamento anterior cruzado: Un estudio prospectivo a corto plazo en 105 pacientes.

Asano H, Muneta T, Ikeda H, Yagishita K, Kurihara Y, Sekiya I.
Department of Orthopedics, Tokyo Medical and Dental University, Tokyo, Japan. h-asano@mtg.biglobe.ne.jp

PURPOSE: Several reports have shown the progression of degenerative osteoarthritis after anterior cruciate ligament (ACL) reconstruction. No report has been published about early cartilage change after ACL reconstruction. The purpose of this study was to evaluate the articular cartilage after ACL reconstruction in a short postoperative period by arthroscopy.

TYPE OF STUDY: Case series.

METHODS: We examined the status of articular cartilage of 105 patients who received ACL reconstruction and second-look arthroscopy. Cartilage lesion was evaluated arthroscopically in the 6 articular surfaces independently, and these features were classified by modified Outerbridge's classification. We compared the articular cartilage at reconstruction and at second-look arthroscopy.

RESULTS: A significant worsening of the status of the articular cartilage was seen after ACL reconstruction. This worsening was seen at all articular surfaces except the lateral femoral condyle. Most of the change involved softening or fibrillation. Anterior laxity and meniscal lesion had no correlation with a progression of degenerative change of articular cartilage. Patient's age influenced the progression of articular cartilage damage after reconstruction significantly in our cases.

CONCLUSIONS: The status of articular cartilage was significantly worsened after ACL reconstruction. Potent risk factors causing articular cartilage damage include female gender and age of 30 years or older. LEVEL OF EVIDENCE: Level IV.

Arthroscopy. 2004 May;20(5):474-81