Osteoarthritic changes after anterior cruciate ligament reconstruction using bone-patellar tendon-bone or hamstring tendon autografts: a retrospective, 7-year radiographic and clinical follow-up study.
OBJECTIVE
This study was undertaken to evaluate the long-term radiographic appearance and clinical outcome after anterior cruciate ligament (ACL) reconstruction by use of either bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) autografts and to evaluate how associated meniscal injuries affect the prevalence of osteoarthritis (OA).


METHODS
ACL reconstruction was performed in 124 consecutive patients. Of these patients, 113 (91%) (72 BPTB and 41 HT) returned for a follow-up examination at a median of 86 months (range, 67 to 111 months) after reconstruction. The patients underwent standard weight-bearing radiographic examinations and clinical evaluation.


RESULTS
The radiographic assessments showed no significant differences between the graft types in terms of OA classified according to the Ahlbäck and Fairbank rating systems. Overall, 23% of the patients had degenerative changes according to the Ahlbäck system, and 74% had degenerative changes according to the Fairbank system. Associated meniscal injuries increased the prevalence of OA. Clinically, no significant differences were found between the graft types in terms of the Tegner activity test, 1-leg hop test, International Knee Documentation Committee evaluation system, disturbed area of sensitivity, manual Lachman test, KT-1000 laxity test (MEDmetric, San Diego, CA), and knee-walking test. The Lysholm score (P = .02) and knee-walking ability (P = .02) were significantly better in the HT group.


CONCLUSIONS
At a median of 7 years after ACL reconstruction with either BPTB or HT autografts, the prevalence of OA as seen on standard weight-bearing radiographs and the clinical outcome were comparable. The presence of meniscal injuries increased the prevalence of OA.


METHODS
Level III, therapeutic, retrospective comparative study.
Lidén
Mattias
M
Department of Plastic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden. mattias.liden@vgregion.se
Sernert
Ninni
N
Rostgård-Christensen
Lars
L
Kartus
Catarina
C
Ejerhed
Lars
L
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001175:Arthrography; D050376:Bone-Patellar Tendon-Bone Grafting; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000150:complications; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D013710:Tendons / Q000637:transplantation*; D000070600:Tibial Meniscus Injuries; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D016474:Weight-Bearing