Journal of Cartilage & Joint Preservation (Sep 2023)
Concurrent meniscus and chondral injuries after anterior cruciate ligament injury are more common in elite versus recreational alpine skiers: a systematic review
Abstract
Background: The anterior cruciate ligament (ACL) has been extensively studied in those with alpine skiing injuries; however, less focus has been given to meniscal/chondral injuries in this population. Objectives: To perform a systematic review investigating the incidence of meniscal/chondral injuries in alpine skiers who have sustained an ACL injury. Data sources: MEDLINE, Scopus, manual journal searches. Study eligibility criteria: Studies reporting rates of meniscal and/or chondral injuries in alpine skiers with an ACL tear were included. Techniques, revisions, non-alpine skiers, and studies lacking an association between skiing and ACL diagnosis were excluded. Participants and interventions: Alpine skiers with a diagnosis of an ACL tear. Study appraisal and synthesis methods: MINORS criteria. Results: Nine hundred fifty-eight studies were identified. Screening, removal of duplicates, and assessment for inclusion/exclusion criteria resulted in 12 level III/IV studies for review. A total of 1185 skiers with ACL injuries were included (209 elite and 976 recreational). Meniscal tears were present in 47.4% of the skiers, with an increased rate seen in elite versus recreational skiers (61.2% vs 43.2%). Elite skiers were more likely to have a combined medial/lateral meniscal injury and a lateral meniscal tear repair (69.8% vs 19.2% for the latter). There were no differences in medial meniscal tear treatment. Chondral injuries presented at a rate of 11.2% and were more common in elite versus recreational skiers (20.3% vs 5.3%). Limitations: Heterogenous nature of study types included; Did not include larger databases and was limited to alpine skiing studies only; demographics were not part of the analysis. Conclusions: Approximately 47% of the alpine skiers with an ACL injury sustained a concomitant meniscal tear, with 11% having an associated chondral injury. Meniscal/chondral injuries are more common in elite skiers, and they are more likely to have their meniscus repaired. Implications of key findings: Careful consideration of the accompanying pathology is warranted in alpine skiers who present with ACL injury. Systematic review registration number: PROSPERO: CRD42022373207.
