title: Knee laxity after complete anterior cruciate ligament tear: a prospective study over 15 years.
abstract: There is limited knowledge of knee laxity in the long term after a complete anterior cruciate ligament (ACL) tear treated without ACL reconstruction. The aim of this study was (1) to describe the clinical course of knee laxity after a complete ACL tear over 15 years, and (2) to study the association between knee laxity and meniscal injuries and the development of knee osteoarthritis (OA). We studied 100 consecutive subjects [mean (SD) age 26 (8) years] presenting with acute ACL injury prospectively. The initial treatment in all subjects was knee rehabilitation without reconstructive surgery. The subjects were examined with Lachman's and pivot-shift tests at baseline, 6 weeks, 3 months, 1 year, 3 years and 15 years after the injury. Sagittal knee laxity was also evaluated with the KT-1000 arthrometer at the 15-year follow-up. During follow-up, 22 subjects were ACL reconstructed due to unacceptable knee instability. There was only a mild remaining knee laxity [median Lachman grade and pivot-shift test value of 1 on a 4-grade scale (0-3)] after 15 years in subjects treated without primary ACL reconstruction. Knees with higher anterior sagittal knee laxity 3 months after the injury had a worse long-term outcome with respect to meniscal injuries and knee OA development.
authors.affiliation: Department of Orthopedics, Institute of Clinical Sciences, Lund University, Lund, Sweden. paul.neuman@skane.se
authors.forename: P
authors.initials: P
authors.lastname: Neuman
authors.forename: I
authors.initials: I
authors.lastname: Kostogiannis
authors.forename: T
authors.initials: T
authors.lastname: Fridén
authors.forename: H
authors.initials: H
authors.lastname: Roos
authors.forename: L E
authors.initials: LE
authors.lastname: Dahlberg
authors.forename: M
authors.initials: M
authors.lastname: Englund
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D053587:Arthrometry, Articular; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000503:physiopathology*; D007718:Knee Injuries / Q000150:complications* / Q000534:rehabilitation; D007719:Knee Joint / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D020370:Osteoarthritis, Knee / Q000150:complications; D011446:Prospective Studies; D000070600:Tibial Meniscus Injuries