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Erschienen in: International Orthopaedics 1/2012

01.01.2012 | Original Paper

Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up

verfasst von: Johannes Struewer, Thomas Manfred Frangen, Bernd Ishaque, Christopher Bliemel, Turgay Efe, Steffen Ruchholtz, Ewgeni Ziring

Erschienen in: International Orthopaedics | Ausgabe 1/2012

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Abstract

Purpose

The aim of this investigation was to study patient-reported long-term clinical outcome, instrumental stablitity and prevalence of radiological osteoarthritis (OA) a minimum of ten years after isolated anterior cruciate ligament (ACL) reconstruction.

Methods

An average of 13.5 years after ACL reconstruction with bone–patellar tendon–bone (BTB) autograft, 73 patients were evaluated. Inclusion criteria consisted of an isolated ACL rupture and reconstruction with BPTB graft with no associated intra-articular lesions, in particular, cartilage alterations or meniscal lesions. Clinical assessment was performed using the International Knee Documentation Committee (IKDC) and Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT–1000™ arthrometer. Degree of degenerative changes and prevalence of OA were determined using the Kellgren- Lawrence scale.

Results

Mean follow-up was 13.5 years. Mean age was 43.8 years. About 75% of patients were graded A or B according to the IKDC score. The Lysholm score was 90.2 ± 4.8. Radiological assessment reported degenerative changes of grade II OA in 54.2% of patients. Prevalence of grades III or IV OA was found in 20%. The incidence of OA was significantly correlated with stability and function at long-term follow-up.

Conclusion

Arthroscopic ACL reconstruction using BPTB autograft resulted in a high degree of patient satisfaction and good clinical results on long-term follow-up. A higher degree of OA developed in 20% of patients and was significantly correlated with increased anterior laxity at long-term follow-up.
Literatur
1.
Zurück zum Zitat Anderson AF, Irrgang JJ, Kocher MS, Mann BJ, Harrast JJ (2006) International Knee Documentation Committee. The International Knee Documentation Committee Subjective Knee Evaluation Form: normative data. Am J Sports Med 34:128–135PubMedCrossRef Anderson AF, Irrgang JJ, Kocher MS, Mann BJ, Harrast JJ (2006) International Knee Documentation Committee. The International Knee Documentation Committee Subjective Knee Evaluation Form: normative data. Am J Sports Med 34:128–135PubMedCrossRef
2.
Zurück zum Zitat Biau DJ, Katsahian S, Kartus J et al (2009) Patellar tendon versus hamstring tendon autografts for reconstructing the anterior cruciate ligament: a meta-analysis based on individual patient data. Am J Sports Med 37(12):2470–2478PubMedCrossRef Biau DJ, Katsahian S, Kartus J et al (2009) Patellar tendon versus hamstring tendon autografts for reconstructing the anterior cruciate ligament: a meta-analysis based on individual patient data. Am J Sports Med 37(12):2470–2478PubMedCrossRef
3.
Zurück zum Zitat Church S, Keating JF (2005) Reconstruction of the anterior cruciate ligament: timing of surgery and the incidence of meniscal tears and degenerative change. J Bone Joint Surg Br 87:1639–1642PubMedCrossRef Church S, Keating JF (2005) Reconstruction of the anterior cruciate ligament: timing of surgery and the incidence of meniscal tears and degenerative change. J Bone Joint Surg Br 87:1639–1642PubMedCrossRef
4.
Zurück zum Zitat Cohen M, Amaro JT, Ejnisman B et al (2007) Anterior cruciate ligament reconstruction after 10 to 15 years: association between meniscectomy and osteoarthrosis. Arthroscopy 23(6):629–634PubMedCrossRef Cohen M, Amaro JT, Ejnisman B et al (2007) Anterior cruciate ligament reconstruction after 10 to 15 years: association between meniscectomy and osteoarthrosis. Arthroscopy 23(6):629–634PubMedCrossRef
5.
Zurück zum Zitat Drogset JO, Grontvedt T, Robak OR et al (2006) A sixteen-year follow-up of three operative techniques for the treatment of acute ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 88:944–952PubMedCrossRef Drogset JO, Grontvedt T, Robak OR et al (2006) A sixteen-year follow-up of three operative techniques for the treatment of acute ruptures of the anterior cruciate ligament. J Bone Joint Surg Am 88:944–952PubMedCrossRef
6.
Zurück zum Zitat Fithian DC, Paxton LW, Goltz DH (2002) Fate of the anterior cruciate ligament- injured knee. Orthop Clin North Am 33:621–636PubMedCrossRef Fithian DC, Paxton LW, Goltz DH (2002) Fate of the anterior cruciate ligament- injured knee. Orthop Clin North Am 33:621–636PubMedCrossRef
7.
Zurück zum Zitat Fox JA, Nedeff DD, Bach BR Jr, Spindler KP (2002) Anterior cruciate ligament reconstruction with patellar autograft tendon. Clin Orthop Relat Res 402:53–63PubMedCrossRef Fox JA, Nedeff DD, Bach BR Jr, Spindler KP (2002) Anterior cruciate ligament reconstruction with patellar autograft tendon. Clin Orthop Relat Res 402:53–63PubMedCrossRef
8.
Zurück zum Zitat Hertel P, Behrend H, Cierpinski TS, Musahl V, Widjaja G (2005) ACL reconstruction using bone-patellar tendon-bone press-fit fixation: 10-year clinical results. Knee Surg Sports Traumatol Arthrosc 13:248–255PubMedCrossRef Hertel P, Behrend H, Cierpinski TS, Musahl V, Widjaja G (2005) ACL reconstruction using bone-patellar tendon-bone press-fit fixation: 10-year clinical results. Knee Surg Sports Traumatol Arthrosc 13:248–255PubMedCrossRef
9.
Zurück zum Zitat Jarvela T, Kannus P, Jarvinen M (2001) Anterior cruciate ligament reconstruction in patients with or without accompanying injuries: a re-examination of subjects 5 to 9 years after reconstruction. Arthroscopy 17:818–825PubMed Jarvela T, Kannus P, Jarvinen M (2001) Anterior cruciate ligament reconstruction in patients with or without accompanying injuries: a re-examination of subjects 5 to 9 years after reconstruction. Arthroscopy 17:818–825PubMed
10.
Zurück zum Zitat Keays SL, Newcombe PA, Bullock-Saxton JE, Bullock MI, Keays AC (2010) Factors involved in the development of osteoarthritis following anterior cruciate ligament surgery. Am J Sports Med 38(3):455–463PubMedCrossRef Keays SL, Newcombe PA, Bullock-Saxton JE, Bullock MI, Keays AC (2010) Factors involved in the development of osteoarthritis following anterior cruciate ligament surgery. Am J Sports Med 38(3):455–463PubMedCrossRef
11.
Zurück zum Zitat Kellgren JH, Lawrence JS, Bier F (1963) Genetic factors in generalized Osteoarthritis. Ann Rheum Dis 22:237–255PubMedCrossRef Kellgren JH, Lawrence JS, Bier F (1963) Genetic factors in generalized Osteoarthritis. Ann Rheum Dis 22:237–255PubMedCrossRef
12.
Zurück zum Zitat Laxdal G, Kartus J, Ejerhed L et al (2005) Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients. Arthroscopy 21:958–964PubMedCrossRef Laxdal G, Kartus J, Ejerhed L et al (2005) Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients. Arthroscopy 21:958–964PubMedCrossRef
13.
Zurück zum Zitat Lebel B, Hulet C, Galaud B, Burdin G, Locker B, Vielpeau C (2008) Arthroscopic reconstruction of the anterior cruciate ligament using bonepatellar tendon-bone autograft: a minimum 10-year follow-up. Am J Sports Med 36(7):1275–1282PubMedCrossRef Lebel B, Hulet C, Galaud B, Burdin G, Locker B, Vielpeau C (2008) Arthroscopic reconstruction of the anterior cruciate ligament using bonepatellar tendon-bone autograft: a minimum 10-year follow-up. Am J Sports Med 36(7):1275–1282PubMedCrossRef
14.
Zurück zum Zitat Lohmander LS, Englund PM, Dahl LL, Roos EM (2007) The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 35(10):1756–1769PubMedCrossRef Lohmander LS, Englund PM, Dahl LL, Roos EM (2007) The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 35(10):1756–1769PubMedCrossRef
15.
Zurück zum Zitat Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50(10):3145–3152PubMedCrossRef Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50(10):3145–3152PubMedCrossRef
16.
Zurück zum Zitat Louboutin H, Debarge R, Richou J et al (2008) Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee 16(4):239–244PubMedCrossRef Louboutin H, Debarge R, Richou J et al (2008) Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee 16(4):239–244PubMedCrossRef
17.
Zurück zum Zitat Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef
18.
Zurück zum Zitat Mihelic R, Jurdana H, Jotanovic Z, Madjarevic T, Tudor A (2011) Long-term results of anterior cruciate reconstruction: a comparison with non-operative treatment with a follow-up of 17–20 years. Int Orthop 35(7):1093–1097PubMedCrossRef Mihelic R, Jurdana H, Jotanovic Z, Madjarevic T, Tudor A (2011) Long-term results of anterior cruciate reconstruction: a comparison with non-operative treatment with a follow-up of 17–20 years. Int Orthop 35(7):1093–1097PubMedCrossRef
19.
Zurück zum Zitat Möller E, Weidenhielm L, Werner S (2009) Outcome and knee-related quality of life after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 17:786–794PubMedCrossRef Möller E, Weidenhielm L, Werner S (2009) Outcome and knee-related quality of life after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 17:786–794PubMedCrossRef
20.
Zurück zum Zitat Øiestad BE, Engebretsen L, Storheim K, Risberg MA (2009) Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 37(7):1434–1443PubMedCrossRef Øiestad BE, Engebretsen L, Storheim K, Risberg MA (2009) Knee osteoarthritis after anterior cruciate ligament injury: a systematic review. Am J Sports Med 37(7):1434–1443PubMedCrossRef
21.
Zurück zum Zitat Øiestad BE, Holm I, Gunderson R, Myklebust G, Risberg A (2010) Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up. Am J Sports Med 38(11):2201–2210PubMedCrossRef Øiestad BE, Holm I, Gunderson R, Myklebust G, Risberg A (2010) Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up. Am J Sports Med 38(11):2201–2210PubMedCrossRef
22.
Zurück zum Zitat Pinczewski LA, Lyman J, Salmon LJ, Russell VJ, Roe J, Linklater J (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial. Am J Sports Med 35(4):564–574PubMedCrossRef Pinczewski LA, Lyman J, Salmon LJ, Russell VJ, Roe J, Linklater J (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial. Am J Sports Med 35(4):564–574PubMedCrossRef
23.
Zurück zum Zitat Salmon LJ, Russell VJ, Refshauge K et al (2006) Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: minimum 13-year review. Am J Sports Med 34:721–732PubMedCrossRef Salmon LJ, Russell VJ, Refshauge K et al (2006) Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: minimum 13-year review. Am J Sports Med 34:721–732PubMedCrossRef
24.
Zurück zum Zitat Schiphof D, Boers M, Bierma-Zeinstra SM (2008) Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis. Ann Rheum Dis 67(7):1034–1036PubMedCrossRef Schiphof D, Boers M, Bierma-Zeinstra SM (2008) Differences in descriptions of Kellgren and Lawrence grades of knee osteoarthritis. Ann Rheum Dis 67(7):1034–1036PubMedCrossRef
25.
Zurück zum Zitat Streich NA, Zimmermann D, Bode G et al (2011) Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up. Int Orthop 35(4):607–613PubMedCrossRef Streich NA, Zimmermann D, Bode G et al (2011) Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up. Int Orthop 35(4):607–613PubMedCrossRef
26.
Zurück zum Zitat Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49PubMed
27.
Zurück zum Zitat Tyler TF, McHugh MP, Glim GW et al (1999) Association of KT-1000 measurements with clinical tests of knee stability 1 year following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 29(9):540–545PubMed Tyler TF, McHugh MP, Glim GW et al (1999) Association of KT-1000 measurements with clinical tests of knee stability 1 year following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 29(9):540–545PubMed
28.
Zurück zum Zitat Von Porat A, Roos EM, Roos H (2004) High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Ann Rheum Dis 63:269–273CrossRef Von Porat A, Roos EM, Roos H (2004) High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Ann Rheum Dis 63:269–273CrossRef
29.
Zurück zum Zitat Wu WH, Hackett T, Richmond JC (2002) Effects of meniscal and articular surface status on knee stability, function, and symptoms after anterior cruciate ligament reconstruction: a long-term prospective study. Am J Sports Med 30:845–850PubMed Wu WH, Hackett T, Richmond JC (2002) Effects of meniscal and articular surface status on knee stability, function, and symptoms after anterior cruciate ligament reconstruction: a long-term prospective study. Am J Sports Med 30:845–850PubMed
Metadaten
Titel
Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up
verfasst von
Johannes Struewer
Thomas Manfred Frangen
Bernd Ishaque
Christopher Bliemel
Turgay Efe
Steffen Ruchholtz
Ewgeni Ziring
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 1/2012
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1345-0

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