Matias Costa-Paz1, Ignacio Garcia-Mansilla2, Sebastian Marciano3, Miguel Angel Ayerza2, D Luis Muscolo2. 1. Department of Orthopedic Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: matias.costapaz@gmail.com. 2. Department of Orthopedic Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 3. Department of Research and Statistics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Abstract
BACKGROUND: Few studies in the literature show results with more than 20 years of follow-up after anterior cruciate ligament reconstruction (ACLR). The main purpose of this retrospective study was to describe knee-specific quality of life, functional results and prevalence of osteoarthritis (OA) of the knee in patients with ACLR using bone-patellar tendon-bone (BPTB) autograft with ultra-long-term follow-up. METHODS: Prospective analyzed data included demographics, meniscus status, radiographic OA, KT-1000 arthrometer measurements and physical examinations. KOOS, Lysholm and IKDC subjective surveys were conducted. Multivariate and univariate logistic models were used to determine the effect of potential predictors of OA and symptomatic knees. RESULTS: Seventy-two knees were included at a median follow-up of 22 (IQR 21-25) years postoperatively. Radiographic scores were normal in 15%, nearly normal in 57%, abnormal in 18% and severely abnormal in 10%. Multivariate analysis showed that the predictive factor for the presence of OA in the long-term was an associated meniscal lesion; patients with meniscal lesions were 3.9 times as likely to develop OA in comparison with those without meniscal injury. The subjective scores were progressively and significantly lower as the level of OA was greater. CONCLUSION: At a median of 22 years of follow-up, this study shows that patellar tendon autograft ACL reconstruction provides good clinical outcomes, with clinically objective knee stability and a 28% prevalence of OA. Additionally, we identified that meniscal injury at time of surgery was an independent predictor of OA. LEVEL OF EVIDENCE: Level IV; case series.
BACKGROUND: Few studies in the literature show results with more than 20 years of follow-up after anterior cruciate ligament reconstruction (ACLR). The main purpose of this retrospective study was to describe knee-specific quality of life, functional results and prevalence of osteoarthritis (OA) of the knee in patients with ACLR using bone-patellar tendon-bone (BPTB) autograft with ultra-long-term follow-up. METHODS: Prospective analyzed data included demographics, meniscus status, radiographic OA, KT-1000 arthrometer measurements and physical examinations. KOOS, Lysholm and IKDC subjective surveys were conducted. Multivariate and univariate logistic models were used to determine the effect of potential predictors of OA and symptomatic knees. RESULTS: Seventy-two knees were included at a median follow-up of 22 (IQR 21-25) years postoperatively. Radiographic scores were normal in 15%, nearly normal in 57%, abnormal in 18% and severely abnormal in 10%. Multivariate analysis showed that the predictive factor for the presence of OA in the long-term was an associated meniscal lesion; patients with meniscal lesions were 3.9 times as likely to develop OA in comparison with those without meniscal injury. The subjective scores were progressively and significantly lower as the level of OA was greater. CONCLUSION: At a median of 22 years of follow-up, this study shows that patellar tendon autograft ACL reconstruction provides good clinical outcomes, with clinically objective knee stability and a 28% prevalence of OA. Additionally, we identified that meniscal injury at time of surgery was an independent predictor of OA. LEVEL OF EVIDENCE: Level IV; case series.
Authors: Matias Costa-Paz; D Luis Muscolo; Miguel A Ayerza; Marisa Sanchez; Juan Astoul Bonorino; Carlos Yacuzzi; Lisandro Carbo Journal: Bone Jt Open Date: 2021-01-03
Authors: Alberto Grassi; Nicola Pizza; Belal Bashar Hamdan Al-Zu'bi; Giacomo Dal Fabbro; Gian Andrea Lucidi; Stefano Zaffagnini Journal: Orthop J Sports Med Date: 2022-01-07