Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleLong-Term Results of Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone: An Analysis of the Factors Affecting the Development of Osteoarthritis
Section snippets
Participants and Preoperative Demographics
Between March 1997 and September 2001, 191 consecutive arthroscopic ACL reconstructions using BPTB autograft were performed at our institute. We excluded 45 of these patients because of either an associated ligament injury requiring surgery, prior knee surgery including meniscectomy, or bilateral ACL injuries. The inclusion criterion was primary ACL reconstruction using BPTB autograft with or without meniscal injury. Of the 146 patients included, 117 (80.1%) returned for clinical and radiologic
Clinical Evaluation
The mean preoperative Lysholm and HSS scores were 72.5 ± 12.5 (range, 27 to 90) and 78.1 ± 12.2 (range, 27 to 91), respectively. The mean postoperative Lysholm and HSS scores were 88.5 ± 7.6 (range, 65 to 100) and 87.4 ± 5.0 (range, 63 to 100), respectively. There was a significant increase in Lysholm score (P < .001) and HSS score (P < .001) at final follow-up. At follow-up, the mean IKDC 2000 subjective score and the mean Tegner score were 90.6 ± 10.3 (range, 51 to 100) and 6.2 ± 1.2 (range,
Discussion
This article reports the long-term clinical results of ACL reconstruction using BPTB autograft with particular attention to the development of knee OA. An analysis of the factors that might contribute to the progression of knee OA in the medial, lateral, and patellofemoral compartments separately by use of multiple logistic regression is also provided. Keays et al.12 evaluated the factors involved in the development of OA of the tibiofemoral joint and patellofemoral joint separately at 6 years
Conclusions
Arthroscopic ACL reconstruction with BPTB autograft showed satisfactory clinical results after a mean of 10.3 years. However, pain when walking on hard ground (38.4%) and numbness of the skin (37.6%) were reported. Moreover, the onset of OA appeared in over 40% of the patients. The onset of OA in the medial compartment was correlated with partial meniscectomy and sagittal tibial tunnel position, and the onset of OA in the lateral compartment was correlated with higher BMI.
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Persistent underloading of patellofemoral joint following hamstring autograft ACL reconstruction is associated with cartilage health
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2020, Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and TechnologyPrevalence of patellofemoral joint osteoarthritis after anterior cruciate ligament injury and associated risk factors: A systematic review
2020, Journal of Orthopaedic TranslationJapanese Orthopaedic Association (JOA) clinical practice guidelines on the management of anterior cruciate ligament injury – Secondary publication
2020, Journal of Orthopaedic ScienceCitation Excerpt :Additionally, a chondral lesion of Outerbridge classification grade II or worse in the medial tibio-femoral joint was reported to be an obvious risk factor for knee OA after ACL reconstruction [201]. Since consistent knee instability due to ACL insufficiency leads to knee OA, it is highly possible to reduce the risk of knee OA by ACL reconstruction, especially for ACL-injured knees with concomitant meniscal tears [103,202–223]. In the guideline committee meeting, 1 committee member (14.3%) advocated “recommendation” of ACL reconstruction and 6 members (85.7%) supported the “suggestion” for this CQ.
The authors report that they have no conflicts of interest in the authorship and publication of this article.