No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years

Tsoukas, Dimitrios; Fotopoulos, V.Ch.; Basdekis, Georgios; Makridis, Konstantinos G.

doi:10.1007/s00167-015-3593-9

Cited by 70 publications

(112 citation statements)

References 40 publications

(51 reference statements)

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“…ACL reconstruction is a commonly performed procedure that generally has excellent clinical outcomes. Numerous long term studies, however, have questioned its ability to prevent degenerative changes compared to non‐operative treatments . It has been suggested that abnormal kinematics after ACL reconstruction might be a factor predisposing the knee to these degenerative changes …”

Section: Resultsmentioning

confidence: 99%

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Effects of ACL graft placement on in vivo knee function and cartilage thickness distributions

DeFrate

2017

J. Orthop. Res.

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Injuries to the anterior cruciate ligament (ACL) frequently lead to early-onset osteoarthritis. Despite advancement in surgical techniques, ACL reconstruction has a limited ability to prevent these degenerative changes. While previous studies have investigated knee function after ACL reconstruction, in vivo investigations of the effects of graft placement on in vivo joint function and cartilage health are limited. This review presents a series of studies that used novel imaging and 3D modeling techniques to determine the in vivo placement of the ACL graft on the femur using two different ACL reconstruction techniques. These techniques resulted in two distinct graft placement groups: one where the ACL was placed anatomically near the center of the native ACL footprint and another where the graft was placed anteroproximally on the femur, centered outside the ACL footprint. We quantified the effects of graft placement on graft deformation during in vivo loading and how these variables affected knee motion. Finally, we quantified whether femoral placement of the graft affected cartilage thickness. Our results demonstrate that achieving anatomic graft placement on the femur is critical to restoring native ACL function and normal knee kinematics. Knees with grafts that more closely restored normal ACL function, and thus knee motion, experienced less focal cartilage thinning than did those that experienced abnormal knee motion. These results suggest that achieving anatomic graft placement is a critical factor in restoring normal knee motion and potentially slowing the development of degenerative changes after ACL reconstruction.

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Section: Resultsmentioning

confidence: 99%

“…Others have reported OA in more than 50% of patients 12–13 years after surgery . Despite advances in reconstructive techniques, early‐onset OA after ACL reconstruction remains a problem …”

Section: In Vivo Measurement Of Acl Graft Placement On the Femurmentioning

confidence: 99%

Effects of ACL graft placement on in vivo knee function and cartilage thickness distributions

DeFrate

2017

J. Orthop. Res.

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“…meniscus injuries) are important risk factors for developing osteoarthritis 22 . ACLR does alter the risk of early onset of osteoarthritis, compared to non-operative treatment 22,122 .…”

Section: Short-and Long-term Consequences After Acl Injurymentioning

confidence: 99%

Treatment Decision after Anterior Cruciate Ligament Injury, and Evaluation of Measurement Properties of a Patient Reported Outcome Measure

Grevnerts

2019

Linköping University Medical Dissertations

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Background: After an ACL injury, treatment aims to restore knee function. Evaluation of treatment progress is important, and adequate measurement methods are necessary. The International Knee Documentation Committee-Subjective Knee Form (IKDC-SKF) is a common patient-reported outcome measure (PROM) used after ACL injury. It evaluates symptoms, function and physical activity. The IKDC-SKF had not been translated to Swedish language for use in Swedish clinical and research settings. The measurement properties of the IKDC-SKF had been tested, but no assessment of methodological quality of the studies investigating it, nor compiling of results, was published. Sooner or later after an ACL injury, a treatment decision must be made. Treatment options are either ACL reconstruction (ACLR) plus rehabilitation, or rehabilitation alone. There are guidelines stating that a decision for ACLR should be made if the patient has high activity demands and/or knee joint instability. It is unclear which factors orthopaedic surgeons and physiotherapists prioritise when recommending ACLR. It is also unclear when the decision for treatment is taken, on what grounds, and how treatment decision correlates to patients reported symptoms and function. Aims: The overall aim of this thesis was to evaluate the measurement properties of a patient-reported measure for evaluation of function after ACL injury and treatment, and to overview the treatment decision process after an ACL injury. Methods: A systematic review was conducted to assess the measurement properties of the IKDC-SKF. The IKDC-SKF was translated from English to Swedish, and the Swedish version was tested for reliability, validity, responsiveness and interpretability. A survey study was conducted, where 98 orthopaedic surgeons and 391 physiotherapists rated 21 predefined factors based on importance to the decision for ACLR. Orthopaedic surgeons and physiotherapists rated how important they considered their own and each other's assesments and patient's wishes for treatment decision making. In a prospective cohort study, patients with an ACL injury were followed from within 6 weeks up to 12 months after injury. Data regarding treatment chosen,

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“…An ACL reconstruction is the procedure that has been proven to improve knee stability and functional outcomes. Although there have been no clear benefits and prevention of osteoarthritic changes following ACL reconstruction [1,2], some studies have proven that this operative procedure can prevent these changes and subsequent meniscal injuries [3,4].…”

Section: Introductionmentioning

confidence: 99%

Anatomic Single-Bundle ACL Reconstruction with Remnant Augmentation Technique

Apivatgaroon¹

2018

Recent Advances in Arthroscopic Surgery

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Anterior cruciate ligament (ACL) injury is the common ligamentous injury of the knees. An ACL reconstruction is the procedure that has been proven to improve knee stability and functional outcomes and may prevent the osteoarthritic changes and subsequent meniscal injuries. The ACL reconstruction techniques have been developed in various ways. Anatomical single-bundle ACL reconstruction with remnant augmentation technique is the optimal reconstruction procedure. It may improve the clinical outcomes of biological healing, preserve the proprioceptive function, and has shown less tibial tunnel widening postoperatively. This chapter presents the step-by-step technique of an anatomical single-bundle ACL reconstruction, indication and contraindication for surgery, the preferred graft choice, fixation methods, pearls and pitfalls of the procedure, and postoperative rehabilitation. The review of literatures about the remnant preserving ACL reconstruction is also discussed in this chapter.

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No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years

Abstract: Prospective randomized study, Level II.

Cited by 70 publications

References 40 publications

Effects of ACL graft placement on in vivo knee function and cartilage thickness distributions

Effects of ACL graft placement on in vivo knee function and cartilage thickness distributions

Treatment Decision after Anterior Cruciate Ligament Injury, and Evaluation of Measurement Properties of a Patient Reported Outcome Measure

Anatomic Single-Bundle ACL Reconstruction with Remnant Augmentation Technique

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