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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2016

01-09-2016 | Knee

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

Authors: Dimitrios Tsoukas, Vasilios Fotopoulos, Georgios Basdekis, Konstantinos G. Makridis

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2016

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Abstract

Purpose

Aim of this study was to record and compare the functional and activity level as well as the manifestations of osteoarthritis after isolated ACL ruptures between patients with conservative treatment and ACL reconstruction with hamstrings tendon graft.

Methods

Thirty-two patients diagnosed with ACL rupture were recorded. Clinical examination included the Tegner and Lysholm activity scale, the International Knee Documentation Committee Subjective Form and KT-1000 arthrometer. Narrowing of the medial and lateral joint spaces was assessed using the IKDC knee examination score.

Results

Median follow-up was 10.3 years (range 10–11). Fifteen patients were conservatively treated (median age 33 years, range 25–39). Seventeen patients were operated (median age 31 years, range 20–36). There was significant difference between the mean values of IKDC scores in favour of the ACL-reconstruction group of patients, 86.8 (SD 6.5) versus 77.5 (SD 13.8), respectively (p = 0.04). The mean value of anteroposterior tibial translation was 1.5 mm (SD 0.2) for ACL-reconstruction group of patients, while the corresponding mean value for ACL-conservative group was 4.5 mm (SD 0.5), p = 0.03. Four patients in ACL-reconstruction group had radiological findings of grade C or D according to IKDC form. In ACL-conservative group, five patients presented similar signs (n.s.).

Conclusions

ACL reconstruction using hamstrings autograft resulted in better functional outcome and laxity measurements than ACL-conservative management. However, the incidence of radiological osteoarthritis was similar between the two groups and independent on the pre-operative grade of laxity and functional status of the patients. Equally, bone bruises were not found as a risk factor for the development of osteoarthritis after ACL rupture.

Level of evidence

Prospective randomized study, Level II.
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Metadata
Title
No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years
Authors
Dimitrios Tsoukas
Vasilios Fotopoulos
Georgios Basdekis
Konstantinos G. Makridis
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3593-9

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