Clinical relevance of chondral lesions in the treatment of the ACL-deficient knee: Microfracture technique

Abstract

An intimate relationship exists between anterior cruciate ligament (ACL) injuries and chondral injuries, especially in athletes [ 2, 10, 13, 25 ]. In the setting of ACL injuries, cartilage injury is often discussed as either focal chondral lesions or chronic chondral degeneration that occurs over time following the injury. In reality, this dichotomy is certainly more intertwined. When the ACL actually ruptures, chondral injury to some extent nearly always occurs. While this relationship may seem intuitive given the consistent “kissing” contusion seen on MRI in the lateral compartment following acute injury, this fact is supported strongly by a recent study in which 100 % of “isolated” ACL tears (42 knees in 40 patients) had MRI evidence of chondral injury when the imaging study was performed within 8 weeks of the knee injury [ 16 ].