Factors Associated With Meniscal and Articular Cartilage Injury in the PLUTO Cohort

Abstract

Background: Anterior cruciate ligament (ACL) injuries in adults are frequently accompanied by meniscal and articular cartilage damage. However, little is known regarding the association, if any, between physical maturity, hypermobility, or bone bruising and these associated injuries in skeletally immature patients with ACL tears. Purpose: To determine if physical maturity, hypermobility, and/or bone bruising is associated with concomitant meniscal and articular cartilage injury in skeletally immature patients with ACL tears. Study Design: Cohort study; Level of evidence, 2. Methods: At 10 institutions in the United States, consecutive skeletally immature patients with complete ACL tears were enrolled between January 2016 and June 2020. Univariable and multivariable logistic regression analysis was used to assess the effect of variables on the likelihood of articular cartilage and meniscal injury. Results: A total of 748 patients were analyzed. Of these, 85 patients (11.4%) had articular cartilage injuries. These patients had a higher bone age (13.9 vs 13.1 years; P = .001), a higher Tanner stage ( P = .009), and increased height (162.9 vs 159.9 cm; P = .03) and were heavier (57.8 vs 54.0 kg; P = .02). For each additional Tanner stage, the odds of articular cartilage injury increased approximately 1.6 times ( P < .001). Of the total patients, 423 (56.6%) had meniscal tears. Those with meniscal tears were older (12.6 vs 12.0 years; P < .001), had a higher bone age (13.5 vs 12.8 years; P < .001), had a higher Tanner stage ( P = .002), had increased height (162.2 vs 157.6 cm; P < .001), and were heavier (56.6 vs 51.6 kg; P < .001). For each additional Tanner stage, the odds of a meniscal tear increased approximately 1.3 times ( P < .001). No association was detected between hypermobility or bone bruising and the likelihood of articular cartilage or meniscal injury. Multivariable regression revealed that increasing Tanner stage was associated with an increasing risk of articular cartilage injury, while weight was associated with an increasing risk of meniscal injury. Conclusion: Increasing physical maturity is associated with increased risks of concomitant articular cartilage and meniscal injury in skeletally immature patients with ACL tears. Hypermobility and bone bruising are not associated with articular cartilage or meniscal injury, suggesting that physical maturity, rather than ligamentous laxity, is the primary risk factor for associated injuries in skeletally immature patients with an ACL tear.

Research progress of procyanidins in repairing cartilage injury after anterior cruciate ligament tear

“…However, the evidence supporting the efficacy of reconstruction in preventing cartilage injury remains insufficient. A study has shown that approximately 11.4% of ACL tear patients are diagnosed with cartilage injury [ 8 ], accompanied by pain and functional impairments. The resulting pain and loss of function significantly affect individuals' physical well-being, contributing to substantial economic burdens in developed countries, representing 1%–2.5% of the gross domestic product [ 9 ].…”

Enhancing cartilage regeneration and repair through bioactive and biomechanical modification of 3D acellular dermal matrix

“…Articular cartilage injury (ACI) refers to the damage or destruction of the cartilage on the surface of joints. There are various factors that can lead to ACI, including accidental falls, sports injuries or accidents resulting in joint twists or impacts; prolonged or excessive use of a joint; inflammatory joint diseases, such as rheumatoid arthritis; and other inflammatory conditions [ 1 ]. Repairing articular cartilage damage is challenging due to its limited self-repair ability caused by the absence of blood vessels and nerves [ 2 ].…”

Cartilage tissue healing and regeneration based on biocompatible materials: a systematic review and bibliometric analysis from 1993 to 2022

“…Cartilage injuries, especially those involving articular cartilage, are prevalent among physically active individuals. Such injuries predominantly affect the knee but can manifest in other aforementioned joints ( Matava et al, 2023 ). The underlying causes of cartilage damage are manifold, ranging from forceful impacts due to sports injuries or accidental falls to progressive wear and tear over extended periods of usage.…”