Concurrent meniscus and chondral injuries after anterior cruciate ligament injury are more common in elite versus recreational alpine skiers: a systematic review

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.