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Radiographic and Symptomatic Knee Osteoarthritis 32 to 37 Years After Acute Anterior Cruciate Ligament Rupture
- Source :
- The American Journal of Sports Medicine
- Publication Year :
- 2020
-
Abstract
- 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)
- Subjects :
- Adult
Male
medicine.medical_specialty
Anterior cruciate ligament reconstruction
Adolescent
Anterior cruciate ligament
Radiography
medicine.medical_treatment
Arthritis
Physical Therapy, Sports Therapy and Rehabilitation
Osteoarthritis
ACL surgery
ACL repair
nonoperative management
radiographic osteoarthritis
symptomatic osteoarthritis
Cohort Studies
03 medical and health sciences
Young Adult
0302 clinical medicine
medicine
Humans
Orthopedics and Sports Medicine
In patient
Knee
Anterior cruciate ligament rupture
Uncategorized
030222 orthopedics
Anterior Cruciate Ligament Reconstruction
business.industry
Kirurgi
Anterior Cruciate Ligament Injuries
030229 sport sciences
Articles
Osteoarthritis, Knee
medicine.disease
musculoskeletal system
Surgery
medicine.anatomical_structure
surgical procedures, operative
Orthopedic surgery
Female
business
human activities
Subjects
Details
- ISSN :
- 15523365
- Volume :
- 48
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The American journal of sports medicine
- Accession number :
- edsair.doi.dedup.....e6051fb66f82f8105f3dfe26d0e10575