Delayed PCLR and older age linked to more cartilage and meniscal injuries

What the study found: Delayed posterior cruciate ligament reconstruction (PCLR), especially when surgery occurred more than 24 months after injury, was associated with a higher prevalence of several cartilage and meniscal injuries. Older age was also associated with more cartilage and meniscal injuries, and higher body mass index (BMI) was linked to more patellofemoral cartilage injury.
Why the authors say this matters: The authors conclude that delayed PCLR, older age, and higher BMI are important factors related to a higher prevalence of concomitant injuries after grade III posterior cruciate ligament (PCL) injuries. They also report that patients with surgery delayed beyond 24 months had higher preoperative visual analog scale (pain) scores.
What the researchers tested: The researchers retrospectively reviewed 1003 patients who had primary isolated PCLR between August 2016 and July 2024. Cartilage and meniscal injuries were confirmed arthroscopically, cartilage damage was graded using the International Cartilage Repair Society classification, and multivariable logistic regression was used to identify independent risk factors.
What worked and what didn't: Longer time from injury to surgery, especially more than 24 months, was significantly associated with patellofemoral cartilage injury, lateral compartment cartilage injury, medial compartment cartilage injury, and medial meniscal injury compared with surgery within 3 months. Older age significantly increased the prevalence of all cartilage and meniscal injuries, while increased BMI was independently associated with higher patellofemoral cartilage injury. The abstract does not report benefits of earlier surgery beyond these associations.
What to keep in mind: This was a retrospective cohort study with level III evidence, so the findings describe associations rather than proof of cause and effect. The abstract does not provide other limitations beyond the study design.

Key points

• PCLR delayed beyond 24 months was linked to higher rates of several cartilage and meniscal injuries.
• Older age was associated with a higher prevalence of all cartilage and meniscal injuries reported.
• Higher BMI was independently associated with patellofemoral cartilage injury.
• The study reviewed 1003 patients who had primary isolated PCLR.
• Patients with surgery delayed more than 24 months reported higher preoperative pain scores.