Cartilage, Meniscus, and Ligaments--Oh My!Oz's tin man needed a heart, and people undergoing anterior cruciate ligament (ACL) reconstruction need a healthy knee. As long as the meniscus isn't torn and the joint surfaces are in good shape at the time of surgery, this is a reasonable goal. In fact, of the 1231 patients in this study who weren't having problems with the meniscus or articular cartilage, 97% were found to have excellent knee health up to 15 years after their ACL surgery. Even their X-rays showed that their knee had good health over this time period. And most patients had returned to their sports and were performing at an intensity level equal to or above their presurgical condition.
The "wizard" is not as optimistic when there are problems with the meniscus or joint cartilage at the time of ACL surgery. People with damaged cartilage or who needed to have part or their entire meniscus removed at the time of ACL surgery reported having more pain and problems as time passed. More damage was related to more symptoms. The knee X-rays taken at follow-up checks (which ranged up to 15.8 years later) showed considerably more arthritis, depending on the amount of damage at the time of surgery. The journey along the yellow brick road of ACL surgery rehab will likely be more challenging for people with damaged cartilage or meniscus at the time of ACL surgery.
Donald K. Shelbourne, MD, et al. Results of Anterior Cruciate Ligament Reconstruction Based on Meniscus and Articular Cartilage Status at the Time of Surgery: Five to Fifteen-Year Evaluations. In The American Journal of Sports Medicine. July/August 2000. Vol. 28. No. 4. Pp. 446-452.
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