Higher frequency of osteoarthritis in patients with ACL graft rupture than in those with intact ACL grafts 30 years after reconstruction

• PURPOSE: The aim was to assess the results of anterior cruciate ligament (ACL) reconstruction regarding graft failure, knee laxity, and osteoarthritis (OA) from a longterm perspective. It was hypothesized that intact ACL graft reduces the risk for increased OA development.METHODS: The cohort comprised 60 patients with a median follow-up 31 (range 28-33) years after ACL reconstruction. They were evaluated with magnetic resonance imaging, radiography, KT-1000 arthrometer and the pivot shift test.RESULTS: Out of the 60 patients, 30 (50%) showed an intact ACL graft and 30 (50%) a ruptured or absent ACL graft. Patients with ruptured ACL grafts had more medial tibiofemoral compartment OA than those with an intact ACL graft (p = 0.0003). OA was asymmetric in patients with ruptured ACL grafts with more OA in the medial than in the lateral tibiofemoral compartment (p = 0.013) and the patellofemoral compartment (p = 0.002). The distribution of OA between compartments was similar in patients with an intact ACL graft. KT-1000 values of anterior knee laxity were higher in patients with ruptured compared to those with intact ACL grafts (p = 0.012). Side-to-side comparisons of anterior knee laxity showed higher KT-1000 values in patients with ruptured ACL graft (p = 0.0003) and similar results in those with intact graft (p = 0.09). The pivot shift grade was higher in the group with a ruptured ACL graft (p < 0.0001).CONCLUSIONS: Median 31 (range 28-33) years after ACL reconstruction, 50% of the patients showed an intact ACL graft and no side-to-side difference regarding anterior knee laxity. Patients with ruptured ACL grafts had more OA of the medial tibiofemoral compartment than those with intact ACL grafts.LEVEL OF EVIDENCE: Retrospective cohort study, Level III.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Nyckelord

ACL reconstruction

Knee laxity

Long-term evaluation

Magnetic resonance imaging

Osteoarthritis

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)