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Archives of Orthopaedic and Trauma Surgery

Published in:

01-03-2018 | Arthroscopy and Sports Medicine

Degenerative changes after posterior cruciate ligament reconstruction are irrespective of posterior knee stability: MRI-based long-term results

Authors: Clemens Gwinner, Andreas Weiler, Timm Denecke, Julian M. M. Rogasch, Heide Boeth, Tobias M. Jung

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2018

Abstract

Introduction

Posterior cruciate ligament reconstruction (PCLR) is advocated to prevent an early onset of osteoarthritis. We hypothesized that posterior instability after PCLR correlates with degenerative changes.

Materials and methods

MRIs of 42 (12 female/30 male; 39 ± 9 years) patients were enrolled with a minimum 5-year follow-up (FFU) after PCLR. In addition, 25 contralateral and 15 follow-up MRIs (12 months after baseline) were performed. Degenerative changes were graded using WORMS. Posterior tibial translation (PTT) was measured using posterior stress radiographs. Outcome parameters included WORMS/cartilage subscore for the whole joint, patellofemoral (PFJ), medial (MFTJ), and lateral femorotibial joint (LFTJ).

Results

Final follow-up was 101 (range 68–168) months. WORMS reached 41.5 [18.5–56.8]. Regional WORMS for PFJ was significantly higher than MFTJ and LFTJ. Cartilage subscore yielded 7 [2.8–15]. MFTJ and PFJ were significantly higher than LFTJ. Primary outcome parameters were significantly higher than the contralateral knee (P < 0.0001) and significantly increased within 12 months (P = 0.0002). There was a significant correlation between the intraoperative degree of cartilage injury and WORMS (P < 0.0001 with r = 0.64) and between the number of previous surgery and the cartilage subscore (P = 0.03 with r = 0.32). Meniscal surgery led to a significantly higher WORMS (P = 0.035). Combined risk models revealed that women below the mean age had significantly lower WORMS (P = 0.001) and cartilage subscores (P = 0.003).

Conclusions

Patients undergo degenerative changes after PCLR, which are significantly higher compared to the contralateral knee. These occur predominantly at PFJ/MFTJ and are irrespective of posterior stability. Concomitant meniscus/cartilage injuries and a high number of previous surgeries are further risk factors.

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Title: Degenerative changes after posterior cruciate ligament reconstruction are irrespective of posterior knee stability: MRI-based long-term results
Authors: Clemens Gwinner
Andreas Weiler
Timm Denecke
Julian M. M. Rogasch
Heide Boeth
Tobias M. Jung
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2855-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Degenerative changes after posterior cruciate ligament reconstruction are irrespective of posterior knee stability: MRI-based long-term results

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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