Does early anterior cruciate ligament reconstruction prevent development of meniscal damage? Results from a secondary analysis of a randomised controlled trial
Snoeker, Barbara A. LU ; Roemer, Frank W. LU ; Turkiewicz, Aleksandra LU ; Lohmander, Stefan LU
; Frobell, Richard B.
LU
and Englund, Martin
LU
(2020)
In British Journal of Sports Medicine
54(10).
p.612-617
- Abstract
Objectives To determine development of new and worsening meniscal damage over 5 years after acute anterior cruciate ligament (ACL) injury comparing rehabilitation plus early ACL reconstruction (’early-ACLR’) versus rehabilitation with optional delayed ACL reconstruction (’optional-delayed-ACLR’). Methods We used knee MRIs from the only randomised controlled trial in the field including 121 young adults. One musculoskeletal radiologist read baseline and 5-year follow-up images using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS). We defined development (ie, new and worsening) of meniscal damage both dichotomously and as a sum score representing severity (based on the reclassified ACLOAS meniscus grades). In the full... (More)
Objectives To determine development of new and worsening meniscal damage over 5 years after acute anterior cruciate ligament (ACL) injury comparing rehabilitation plus early ACL reconstruction (’early-ACLR’) versus rehabilitation with optional delayed ACL reconstruction (’optional-delayed-ACLR’). Methods We used knee MRIs from the only randomised controlled trial in the field including 121 young adults. One musculoskeletal radiologist read baseline and 5-year follow-up images using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS). We defined development (ie, new and worsening) of meniscal damage both dichotomously and as a sum score representing severity (based on the reclassified ACLOAS meniscus grades). In the full analysis set, we analysed development of meniscal damage (yes/no) with logistic regression and severity with zero-inflated Poisson regression and adjusted for age, sex and baseline meniscal damage. Results Over 5 years, new or worsening meniscal damage developed in 45% of subjects with early-ACLR and in 53% of subjects with optional-delayed-ACLR. The relative risk for development of meniscal damage on knee level was 1.3 (95% CI 0.9 to 1.9) in optional-delayed-ACLR versus early-ACLR. For medial and lateral meniscal damage, respectively, the relative risks were 2.1 (95% CI 1.1 to 3.9) and 1.0 (95% CI 0.6 to 1.5). The mean severity score was 1.5 higher (more severe damage) on knee level in optional-delayed-ACLR versus early-ACLR (95% CI 1.1 to 1.9) among those with meniscal damage at 5 years. For medial and lateral meniscal damage, respectively, the corresponding scores were 1.7 (95% CI 1.2 to 2.5) and 1.1 (95% CI 0.8 to 1.4). Conclusion A strategy of early-ACLR may reduce development of medial meniscal damage following acute ACL injury. For the lateral meniscus, ACLR seems neither to be protective nor to increase the risk of damage.
(Less)
- author
- Snoeker, Barbara A.
LU
; Roemer, Frank W.
LU
; Turkiewicz, Aleksandra
LU
; Lohmander, Stefan
LU
; Frobell, Richard B.
LU
and Englund, Martin
LU
- organization
- publishing date
- 2020-05-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Sports Medicine
- volume
- 54
- issue
- 10
- pages
- 612 - 617
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85074336474
- pmid:31653779
- ISSN
- 0306-3674
- DOI
- 10.1136/bjsports-2019-101125
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © Author(s) (or their employer(s)) 2020.
- id
- 6452a296-e2ca-47f3-86c1-c195455a78b8
- date added to LUP
- 2026-07-23 16:29:31
- date last changed
- 2026-08-10 08:43:10
@article{6452a296-e2ca-47f3-86c1-c195455a78b8,
abstract = {{<p>Objectives To determine development of new and worsening meniscal damage over 5 years after acute anterior cruciate ligament (ACL) injury comparing rehabilitation plus early ACL reconstruction (’early-ACLR’) versus rehabilitation with optional delayed ACL reconstruction (’optional-delayed-ACLR’). Methods We used knee MRIs from the only randomised controlled trial in the field including 121 young adults. One musculoskeletal radiologist read baseline and 5-year follow-up images using the Anterior Cruciate Ligament Osteoarthritis Score (ACLOAS). We defined development (ie, new and worsening) of meniscal damage both dichotomously and as a sum score representing severity (based on the reclassified ACLOAS meniscus grades). In the full analysis set, we analysed development of meniscal damage (yes/no) with logistic regression and severity with zero-inflated Poisson regression and adjusted for age, sex and baseline meniscal damage. Results Over 5 years, new or worsening meniscal damage developed in 45% of subjects with early-ACLR and in 53% of subjects with optional-delayed-ACLR. The relative risk for development of meniscal damage on knee level was 1.3 (95% CI 0.9 to 1.9) in optional-delayed-ACLR versus early-ACLR. For medial and lateral meniscal damage, respectively, the relative risks were 2.1 (95% CI 1.1 to 3.9) and 1.0 (95% CI 0.6 to 1.5). The mean severity score was 1.5 higher (more severe damage) on knee level in optional-delayed-ACLR versus early-ACLR (95% CI 1.1 to 1.9) among those with meniscal damage at 5 years. For medial and lateral meniscal damage, respectively, the corresponding scores were 1.7 (95% CI 1.2 to 2.5) and 1.1 (95% CI 0.8 to 1.4). Conclusion A strategy of early-ACLR may reduce development of medial meniscal damage following acute ACL injury. For the lateral meniscus, ACLR seems neither to be protective nor to increase the risk of damage.</p>}},
author = {{Snoeker, Barbara A. and Roemer, Frank W. and Turkiewicz, Aleksandra and Lohmander, Stefan and Frobell, Richard B. and Englund, Martin}},
issn = {{0306-3674}},
language = {{eng}},
month = {{05}},
number = {{10}},
pages = {{612--617}},
publisher = {{BMJ Publishing Group}},
series = {{British Journal of Sports Medicine}},
title = {{Does early anterior cruciate ligament reconstruction prevent development of meniscal damage? Results from a secondary analysis of a randomised controlled trial}},
url = {{http://dx.doi.org/10.1136/bjsports-2019-101125}},
doi = {{10.1136/bjsports-2019-101125}},
volume = {{54}},
year = {{2020}},
}