Patellofemoral joint cartilage lesions frequently develop shortly after anterior cruciate ligament reconstruction using hamstring tendon autograft: A systematic review

AbstractPurposeThis study aimed to investigate the development of patellofemoral joint (PFJ) cartilage lesions following anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) autograft through a systematic review.MethodsA comprehensive search was conducted in PubMed, Embase, Cochrane Library and Google Scholar databases to find articles published from database inception until 15 November 2023. The search terms were [(‘Anterior Cruciate Ligament’ [mesh] OR ‘anterior cruciate ligament’ OR ‘ACL’) AND ‘reconstruction’ AND ‘cartilage’ AND (‘second look arthroscopy’ OR ‘second‐look arthroscopy’ OR ‘MRI’ OR ‘magnetic resonance imaging’)]. Inclusion criteria were studies that reported on the occurrence of PFJ cartilage lesions following ACLR using HT autograft, as determined by second‐look arthroscopy or follow‐up magnetic resonance imaging (MRI).ResultsFifteen studies (1084 patients) met the inclusion criteria, with follow‐up periods ranging from 1 to 5 years. In the results of second‐look arthroscopy, cartilage grade deterioration was observed, ranging from MDs of 0.1 to 2.0 in the patella and from 0 to 1.0 in the trochlea. Follow‐up MRI results reported the incidence of PFJ cartilage degeneration with rates ranging from 20% to 44%. Patient‐reported outcome measures often showed no significant association with PFJ cartilage lesions. The studies included in this review reported various risk factors for cartilage lesion development.ConclusionCartilage lesions in the PFJ, detected using second‐look arthroscopy or follow‐up MRI, frequently develop shortly after ACLR using HT autograft. At this stage, patients might not show specific symptoms; however, those with risk factors require careful observation and evaluation by clinicians during follow‐up.Level of EvidenceLevel IV.