Background: Anterior cruciate ligament (ACL) is a critical element in the biomechanics of knee joint stability. ACL tear increases the risk of meniscal and articular cartilage injury. This study evaluated the occurrence of meniscal and chondral injuries and the results of ACL reconstruction with more than 7 years delay in ACL reconstruction.

Methods: In a cross sectional study, 43 patients (39 men, 4 women) at mean age of 38 years, who underwent ACL reconstruction with a delay of more than 7 years, were studied. The Lysholm, IKDC, Tenger and KOOS scores were evaluated before surgery and at the last follow up. The observed meniscal or chondral lesions were collected from the patients’ arthroscopic records. The mean follow-up was 34 months.

Results: The mean time interval between primary trauma and ACL reconstruction surgery was 121 months. A total of 39 cases (90/7%) had chondral lesions which include 20 cases of grade I/II and 19 cases of grade III/IV lesions. In 35 patients (81.4%) meniscal tear was observed. Only two cases (4.6%) had isolated ACL tear. A statistically significant improvement in IKDC, Lysholm, KOOS, and Tegner score was observed following surgical treatment (p < /em><.001).

Conclusions: Longstanding ACL tear leads to increase the occurrence of meniscal and cartilage injuries. Delayed ACL reconstruction in this group of patients can improve IKDC, Lysholm and KOOS knee scores and Tegner activity level.