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The location-specific healing response of damaged articular cartilage after ACL reconstruction: short-term follow-up

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy

Abstract

Although many different interventions have been proposed for treating cartilage lesions at the time of ACL reconstruction, the normal healing response of these injuries has not been well documented. To address this point, we compared the arthroscopic status of chondral lesions at the time of ACL reconstruction with that obtained at second-look arthroscopy. We hypothesized that there might be a location-specific difference in the healing response of damaged articular cartilage. Between September 1998 and March 2000, 383 patients underwent arthroscopically-assisted hamstring ACL reconstruction without any intervention to the articular cartilage. Among these patients, 84 patients underwent second-look arthroscopy (ranging from 6 to 52 months following initial surgery) and make up the population of the present study. Chondral injuries, left untreated at ACL reconstruction, were arthroscopically evaluated using the Outerbridge classification, and were again evaluated at second-look arthroscopy. At second-look arthroscopy, there was significant recovery of chondral lesions by Outerbridge grading on both the medial and lateral femoral condyles. Among the recovered chondral lesions, 69% of cases of the medial femoral condyle, 88% of cases of the lateral femoral condyle were partial thickness injuries (grade I and II). Conversely, there was no significant recovery of chondral lesions observed at the patello-femoral joint or tibial plateaus. Our study revealed that there was a location-specific difference in the natural healing response of chondral injury. Untreated cartilage lesions on the femoral condlyes had a superior healing response compared to those on the tibial plateaus, and in the patello-femoral joint.

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Authors and Affiliations

  1. Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamada-oka Suita, Osaka, 565-0871, Japan

    Norimasa Nakamura, Tomoki Mitsuoka, Kenji Yoneda, Masayuki Hamada & Hideki Yoshikawa

  2. Department of Orthopaedic Sports Medicine, Osaka Rosai Hospital, Osaka, Japan

    Shuji Horibe, Takashi Natsu-ume & Yoshinari Tanaka

  3. Department of Orthopaedic Sports Medicine, Kansai Rosai Hospital, Amagasaki , Japan

    Yukiyoshi Toritsuka

  4. Faculty of Surgery, University of Calgary, Calgary, Canada

    Richard S. Boorman

  5. Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan

    Konsei Shino

Authors
  1. Norimasa Nakamura
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  2. Shuji Horibe
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  3. Yukiyoshi Toritsuka
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  4. Tomoki Mitsuoka
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Correspondence to Norimasa Nakamura.

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Nakamura, N., Horibe, S., Toritsuka, Y. et al. The location-specific healing response of damaged articular cartilage after ACL reconstruction: short-term follow-up. Knee Surg Sports Traumatol Arthr 16, 843–848 (2008). https://doi.org/10.1007/s00167-008-0565-3

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  • DOI: https://doi.org/10.1007/s00167-008-0565-3

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