Radiographic and Symptomatic Knee Osteoarthritis 32 to 37 Years After Acute Anterior Cruciate Ligament Rupture

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Kvist, JoannaKarolinska Institutet,Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Karolinska Inst, Sweden (author)

Radiographic and Symptomatic Knee Osteoarthritis 32 to 37 Years After Acute Anterior Cruciate Ligament Rupture

Article/chapterEnglish2020

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2020-07-31
SAGE PUBLICATIONS INC,2020
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:liu-168212
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-168212URI
https://doi.org/10.1177/0363546520939897DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:144316222URI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Background: The long-term prevalence of knee osteoarthritis (OA) after anterior cruciate ligament (ACL) injury is unknown, especially in patients without a history of ACL surgery. Purpose: To (1) describe the prevalence of radiographic OA, symptomatic OA, and knee replacement surgery 32 to 37 years after acute ACL injury and to (2) compare the prevalence of radiographic OA, symptomatic OA, and knee symptoms between patients allocated to early ACL surgery or no ACL surgery and patients who crossed over to ACL surgery. Study Design: Cohort study; Level of evidence, 2. Methods: Participants aged 15 to 40 years at the time of ACL injury were allocated to surgical (augmented or nonaugmented ACL repair) or nonsurgical ACL treatment within 14 days of injury. At 32 to 37 years after the initial injury, 153 participants were followed up with plain weightbearing radiographs and completed 4 subscales from the Knee injury and Osteoarthritis Outcome Score (KOOS). Radiographic OA was defined as Kellgren and Lawrence grade 2 or higher. Symptomatic OA was defined as radiographic OA plus knee symptoms measured with the KOOS. Results: Participants allocated to ACL surgery (n = 64) underwent surgery at a mean +/- SD of 5 +/- 4 days (range, 0-11 days) after injury. Of the 89 participants allocated to no ACL surgery, 53 remained nonsurgically treated, 27 had ACL surgery within 2 years, and 9 had ACL surgery between 3 and 21 years after injury. In the total sample, 95 participants (62%) had radiographic tibiofemoral OA, including 11 (7%) who had knee replacement. The prevalence of radiographic tibiofemoral OA was lower in the group allocated to ACL surgery compared with the group who never had ACL surgery (50% vs 75%;P= .005). The prevalence of symptomatic OA (50% in the total sample) and patellofemoral radiographic OA (35% in the total sample) was similar between groups. Conclusion: Patients allocated to early ACL surgery, performed a mean 5 days after injury, had a lower prevalence of tibiofemoral radiographic OA at 32 to 37 years after injury compared with patients who never had ACL surgery. The prevalences of symptomatic OA, radiographic patellofemoral OA, and knee symptoms were similar irrespective of ACL treatment. Overall, the prevalence of OA after ACL injury was high. Registration: NCT03182647 (ClinicalTrials.gov identifier)

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
ACL surgery; ACL repair; nonoperative management; radiographic osteoarthritis; symptomatic osteoarthritis

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Filbay, StephanieLinköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Univ Oxford, England(Swepub:liu)n/a (author)
Andersson, Christer A.,1949-Linköpings universitet,Institutionen för biomedicinska och kliniska vetenskaper,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping(Swepub:liu)chran37 (author)
Ardern, ClareKarolinska Institutet,Linköpings universitet,Avdelningen för prevention, rehabilitering och nära vård,Medicinska fakulteten,Karolinska Inst, Sweden; La Trobe Univ, Australia(Swepub:liu)claar40 (author)
Gauffin, HåkanLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping(Swepub:liu)hakga25 (author)
Linköpings universitetAvdelningen för prevention, rehabilitering och nära vård (creator_code:org_t)

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In:American Journal of Sports Medicine: SAGE PUBLICATIONS INC48:10, s. 2387-23940363-54651552-3365

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