Articular cartilage defects, although less common than meniscal pathology, were found in 30% of knees that recently underwent ACL reconstruction.Among patients with a chondral lesion, 80% had a meniscal lesion and the primary ACL rupture in the same compartment. A much smaller retrospective analysis of 1,000 knee arthroscopies found an associated ACL rupture in 26% of chondral defects.

Does chondral damage affect patient outcomes and return to sport ?
Evidence suggests that chondral damage does lead to inferior patient outcomes – especially in cases of full-thickness cartilage lesions.

Defect size matters :
A total of 3,674 patients were assessed on 5 subscales of Knee Injury and Osteoarthritis Outcome Score (KOOS):

  • Pain
  • Other symptoms
  • Function in daily living
  • Function in sport and recreation
  • Knee related Quality of life.

At the 2-year follow-up, patients with full-thickness cartilage lesions reported lower crude mean values for all of the KOOS subscales compared with those without cartilage lesions.

Patients with lesions ≥ 2 cm in diameter also reported poorer outcomes, but the differences were below statistical significance.
Somewhat surprisingly, patient-perceived outcomes remained at the same level in patients with meniscal pathology and smaller chondral lesions (grades I/II) and those without any intra-articular lesions.
Based on these findings, patients with full-thickness cartilage damage reported more pain and symptoms, impaired function in activities of daily living, sports, recreation, and reduced knee-related quality of life compared to those without concomitant chondral damage.