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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 20-04-2022 | Osteoarthrosis | KNEE

Management after acute rupture of the anterior cruciate ligament (ACL). Part 1: ACL reconstruction has a protective effect on secondary meniscus and cartilage lesions

Authors: Wolf Petersen, Daniel Guenther, Andreas B. Imhoff, Mirco Herbort, Thomas Stein, Christian Schoepp, Ralph Akoto, Jürgen Höher, Sven Scheffler, Amelie Stoehr, Thomas Stoffels, Martin Häner, Tilman Hees, Julian Mehl, Andree Ellermann, Matthias Krause, Natalie Mengis, Christian Eberle, Peter E. Müller, Raymond Best, Patricia M. Lutz, Andrea Achtnich

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2023

Abstract

Purpose

The aim of this consensus project was to validate which endogenous and exogenous factors contribute to the development of post-traumatic osteoarthritis and to what extent ACL (anterior cruciate ligament) reconstruction can prevent secondary damage to the knee joint. Based on these findings, an algorithm for the management after ACL rupture should be established.

Methods

The consensus project was initiated by the Ligament Injuries Committee of the German Knee Society (Deutsche Kniegesellschaft, DKG). A modified Delphi process was used to answer scientific questions. This process was based on key topic complexes previously formed during an initial face-to-face meeting of the steering group with the expert group. For each key topic, a comprehensive review of available literature was performed by the steering group. The results of the literature review were sent to the rating group with the option to give anonymous comments until a final consensus voting was performed. Consensus was defined a-priori as eighty percent agreement.

Results

Of the 17 final statements, 15 achieved consensus, and 2 have not reached consensus. Results of the consensus were summarized in an algorithm for the management after ACL rupture (infographic/Fig. 2).

Conclusion

This consensus process has shown that the development of post-traumatic osteoarthritis is a complex multifactorial process. Exogenous (primary and secondary meniscus lesions) and endogenous factors (varus deformity) play a decisive role. Due to the complex interplay of these factors, an ACL reconstruction cannot always halt post-traumatic osteoarthritis of the knee. However, there is evidence that ACL reconstruction can prevent secondary joint damage such as meniscus lesions and that the success of meniscus repair is higher with simultaneous ACL reconstruction. Therefore, we recommend ACL reconstruction in case of a combined injury of the ACL and a meniscus lesion which is suitable for repair.

Level of evidence

Level V.

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Title: Management after acute rupture of the anterior cruciate ligament (ACL). Part 1: ACL reconstruction has a protective effect on secondary meniscus and cartilage lesions
Authors: Wolf Petersen
Daniel Guenther
Andreas B. Imhoff
Mirco Herbort
Thomas Stein
Christian Schoepp
Ralph Akoto
Jürgen Höher
Sven Scheffler
Amelie Stoehr
Thomas Stoffels
Martin Häner
Tilman Hees
Julian Mehl
Andree Ellermann
Matthias Krause
Natalie Mengis
Christian Eberle
Peter E. Müller
Raymond Best
Patricia M. Lutz
Andrea Achtnich
Publication date: 20-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Osteoarthrosis
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-022-06960-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Management after acute rupture of the anterior cruciate ligament (ACL). Part 1: ACL reconstruction has a protective effect on secondary meniscus and cartilage lesions

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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