The influence of secondary damage to joint structures (menisci and articular cartilage) on return to sports activities following anterior cruciate ligament (ACL) reconstruction was investigated. Two hundred and sixty athletes who had undergone ACL reconstruction with the Leeds-Keio artificial ligament and had achieved satisfactory joint stability and range of motion were involved in this study. The follow-up period was 7-50 months (mean, 23.4 months). There was a clear correlation between the severity of damage to the joint structures (the menisci and articular cartilage) and the level of return to sports. The most common reason for not being able to return to the original level of sports activity was 'pain'. Thus, it was concluded that irreversible secondary damage to joint structures was an important factor hindering return to sports after ACL reconstruction. This study showed that the incidence of meniscal injury and cartilage damage increased with the passage of time after ACL injury, and that, once meniscal injury develops, the incidence of cartilage damage increases. Since sports activity is a factor that accelerates or promotes processes that give rise to this meniscal injury and cartilage damage, it was concluded that it is vital to perform ACL reconstruction before irreversible secondary damage to joint structures occurs in athletes with ACL injuries who hope to continue their sports activities.
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