Incidence of concomitant intra- and extra-articular lesions and procedures in patients undergoing primary and subsequent revision single-stage or 2-stage revision anterior cruciate ligament reconstruction: a matched retrospective cohort study.

Abstract

This study compares the concomitant intra- and extra-articular pathologies in patients undergoing primary anterior cruciate ligament reconstruction (ACLR) to their subsequent single or 2-stage revision ACLR. Patients from 2012 to 2021 with minimum two-year follow-up after single-stage revision ACLR were matched with patients who underwent 2-stage revision ACLR by age, sex, and body mass index. Concomitant pathologies and procedures were compared from primary to single or 2-stage revision ACLR. The incidence of concomitant knee pathologies and procedures at the time of primary and revision ACLR was compared between the two groups. Following primary ACLR, 27 patients had single-stage revision ACLR and 27 had 2-stage revision ACLR. At the time of revision surgery, 2-stage revision ACLR had increased incidence of multi-ligamentous injury and meniscus repair. Rates of chondral injury alone and chondral injury plus concomitant meniscal injury increased significantly from primary to 2-stage revision ACLR. No significant change in the incidence of concomitant pathologies or procedures was found at primary ACLR to single-stage revision ACLR. Patients with 2-stage revision ACLR are more likely to have concomitant multi-ligamentous pathologies and meniscal repair at the time of revision. Additionally, 25.9% of patients developed chondral pathologies and 18.55% developed both chondral and meniscal lesions from primary ACLR to 2-stage revision ACLR, raising concern about the long-term outcomes of these patients. Retrospective Cohort; 3.