The hidden cost of delay: meniscal and osteochondral damage in neglected ACL tears

Background: Neglected anterior cruciate ligament (ACL) tears cause repeated incidences of giving-way and rotational-translational instability. The effects of untreated ACL tears and its impact on the meniscus and cartilage was evaluated in this study over a two year time period, especially those with high Tegner activity levels, results in more severe and complicated meniscal and osteochondral lesions with potential affect on the outcome. The study emphasized the importance of early treatment of ACL injury to prevent damage to the meniscal and cartilaginous tissue and secondary osteoarthritis. Methods: This study examined 385 patients who underwent arthroscopic ACL reconstruction between 2022 and 2024. Researchers analyzed arthroscopic findings, MRI scans, and patient records from the time of surgery. The focus was on identifying severe meniscal and osteochondral lesions that could adversely impact patient outcomes. These lesions were classified as meniscal lesions affecting outcome (MLAO) and osteochondral lesions affecting outcome (OLAO). The study also investigated statistical correlations between MLAO, OLAO, time since injury, and Tegner activity levels. Results: The occurrence of MLAO and OLAO increased significantly as the duration between injury and surgery lengthened (p=0.001, p<0.05). However, no statistically significant correlation was found between the Tegner activity score and the risk of MLAO or OLAO (p=0.317, p=0.184, p>0.05). Conclusions: A delay in ACL reconstruction can result in a higher occurrence of meniscal and osteochondral lesions, negatively influencing surgical results.