Meniscal and chondral injury patterns in 331 futsal players undergoing anterior cruciate ligament reconstruction: Revision cases are associated with increased chondral pathology

PURPOSE: The purpose of this study was to characterise the prevalence and pattern of associated meniscal and chondral injuries in futsal players undergoing anterior cruciate ligament (ACL) reconstruction, and to identify independent predictors of concomitant intra-articular pathology. METHODS: We retrospectively analysed 331 consecutive futsal players who underwent ACL reconstruction at a specialised centre (2020-2024). Review of operative reports for ambiguous cases: meniscal tears were classified, excluding healed tears, status post-meniscectomy findings and hypermobile menisci without structural tears. Multivariate logistic regression models were constructed to identify independent predictors of associated injuries. RESULTS: Mean age was 23.0 ± 5.8 years; 67.7% were male. Injury-to-surgery interval was 4.0 ± 3.6 months. Associated injuries were present in 57.1% of cases: meniscal tears in 51.4% and chondral lesions in 20.5%. Among 68 patients with chondral lesions, Outerbridge Grade 1 was most common (36.8%), followed by Grade 2 (42.6%), Grade 3 (13.2%) and Grade 4 (7.4%). Revision cases (10.3%) demonstrated markedly higher chondral lesion prevalence (55.9% vs. 16.2%, p < 0.001). After multivariate adjustment, revision status was independently associated with chondral lesions after adjustment for the included covariates (odds ratio [OR] = 6.36, 95% CI = 2.94-13.74; p < 0.001) and combined meniscal and chondral pathology (OR = 5.09, 95% CI = 2.25-11.49; p < 0.001). In a sensitivity analysis using an Outerbridge Grade ≥ 2 threshold, the association was attenuated and did not reach statistical significance (OR = 2.13, 95% CI = 0.87-5.23; p = 0.097). Neither sex nor playing surface demonstrated independent associations after adjustment. CONCLUSION: Futsal players undergoing ACL reconstruction present with a high prevalence of associated meniscal and chondral lesions. Revision ACL reconstruction is associated with substantially higher odds of chondral abnormalities, predominantly of low Outerbridge grade. Although the clinical significance of these predominantly early cartilage changes requires longitudinal confirmation, their presence in a young athletic population warrants consideration in surgical planning and patient counselling. LEVEL OF EVIDENCE: Level IV, retrospective case series.