Anterior Cruciate Ligament Surgery: Risk Factors for Development of Osteoarthritis: What Can We Do to Prevent It?

Yamazaki, Junya; Engebretsen, Lars

doi:10.1007/978-1-4471-4270-6_4

Cited by 1 publication

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“…This unexpected result may be related to a generally lower level of participation in high‐risk sports at advanced age and the reduced statistical power resulting from the smaller sample size after 20 years of follow‐up. While the effect of physical activity was not statistically significant, our results identified initial lateral meniscectomy as a high‐risk factor for developing osteoarthritis, which is in agreement with the literature [18, 25]. Our data showed no correlation between instrumented arthrometry test results and changes in Fairbank's score reflecting the development of osteoarthritis.…”

Section: Discussionsupporting

confidence: 91%

Non-operative treatment of ACL injury is associated with opposing subjective and objective outcomes over 20 years of follow-up

Gföller

Abermann

Runer

et al. 2018

Knee Surg Sports Traumatol Arthrosc

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Purpose The aim of this study was the evaluation of long-term clinical and radiological outcomes of non-operative treatment of anterior cruciate ligament (ACL) deficiency. The hypothesis was that conservative treatment would be associated with a deterioration of subjective and objective measures of joint health and disability over time. Methods From an initial sample of 41 patients conservatively treated for ACL rupture, 10 received secondary ACL reconstruction, 1 was excluded due to contralateral ACL injury, and 1 patient required total knee replacement and a high tibial osteotomy. Seven further patients were lost to follow-up. The remaining 21 patients (15 male, 6 female, mean age 53.1 ± 9.2 years at the last follow-up) were evaluated by the same two examiners 5-7, 10-13 and 20-22 years after the injury. The evaluation was based on objective and subjective scores, instrumented testing, radiographic examination and assessment of sports activity. Results While subjective patient satisfaction improved over time, objective scores stayed constant or deteriorated (radiologic evaluation). Instrumented knee laxity testing showed an initial tendency to increasing instability, followed by a decrease in anterior tibial translation in the second half of the observation period. Physical activity levels, particularly in high-risk sports, decreased significantly (p < 0.05) compared to preinjury levels. All patients developed significant arthritic degenerative changes over time compared to the uninjured contralateral knee. No correlation to activities in high-or low-risk pivoting sports was found. Conclusions Patient satisfaction with conservative treatment of ACL injuries is good in spite of objective measures indicating increasing degenerative changes. Level of evidence IV.

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Section: Discussionsupporting

confidence: 91%