The evolution of osteoarthritis in 103 patients with ACL reconstruction at 17 years follow-up.
OBJECTIVE
To evaluate the functional and radiological outcome of a bone-tendon-bone anterior cruciate ligament reconstruction, at long-term follow-up.


METHODS
A retrospective study of 148 patients, of which 103 were available for long-term follow-up. Complete functional and radiological evaluation (International Knee Documentation Committee scale) were performed in 89 out of the 103 patients [Anderson AF. Rating scales. In: Fu FH, Harner CD, Vince KG, (Eds.). Knee Surgery, Baltimore, Williams and Wilkins vol. 1, 1994; 12, pp. 275-296].


RESULTS
The mean follow-up time was 17.4 years. Subjectively, 88% of the patients were very satisfied or satisfied. According to the IKDC score 55% had type A symptoms, 29% type B, 12% type C, and 4% type D. The IKDC ligament evaluation showed 14.9% type A, 44.8% type B, 35.8% type C, and 4.5% type D. At the review 22.7% had a narrowing <50% (C) and 4.7% a narrowing >50% (D). Onset of osteoarthritis showed an association with the status of the medial meniscus. Knees with a preserved (healthy or sutured) medial meniscus had a significantly (p < 0.05) better radiological outcome. Among these, 9% had a joint space narrowing <50% (C) and 2% had a narrowing >50% (D). Medial meniscectomy, residual laxity, and femoral chondral defects were associated with osteoarthritis.


CONCLUSIONS
The outcome of anterior cruciate ligament reconstruction plus extra-articular tenodesis is good in the very long term, particularly in knees with a preserved medial meniscus.
Aït Si Selmi
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T
Centre Livet of Orthopaedics Surgery and Traumatology, Hôpital de la Croix Rousse, Centre Livet 69300 Caluire, France. tarik.aitsiselmi@chu-lyon.fr
Fithian
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D
Neyret
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P
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D050376:Bone-Patellar Tendon-Bone Grafting; D002358:Cartilage, Articular / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology / Q000503:physiopathology; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies