The prevalence of patellofemoral osteoarthritis 12 years after anterior cruciate ligament reconstruction.
OBJECTIVE
To investigate the prevalence of patellofemoral osteoarthritis (OA) and to explore the association between radiographic patellofemoral OA and symptoms and function 12 years after anterior cruciate ligament (ACL) reconstruction.


METHODS
The study participants (n = 221) were consecutively included at the time of an ACL reconstruction in the period from 1990 to 1997. Knee laxity (KT-1000), isokinetic quadriceps strength, triple jump, stair hop, and the Cincinnati knee score were measured 6 months, 1 year, 2 years, and 12 years after surgery. At the 12-year follow-up, visual analogue scale for pain, the Knee injury and Osteoarthritis Outcome Score, the Tegner activity scale, and radiographic examination (Kellgren and Lawrence score) were added. To analyse the association between patellofemoral OA, symptoms, and function, binary regression analyses presenting odds ratios and 95 % confidence intervals were used. The analyses were adjusted for age, gender, and body mass index.


RESULTS
One hundred and eighty-one of the 221 subjects (82 %), including 76 females (42 %) and 105 males (58 %), were evaluated at the 12.3 ± 1.2-year follow-up. Mean age at the follow-up was 39.1 ± 8.7 years. Additional meniscal or chondral injuries at the time of reconstruction or during the follow-up period were detected in 116 subjects (64 %). Radiographic patellofemoral OA was found in 48 subjects (26 %), including 3 subjects with isolated patellofemoral OA (1.5 %). Those with patellofemoral OA were older, had more tibiofemoral OA, and had significantly more symptoms and impaired function compared with those without patellofemoral OA.


CONCLUSIONS
Patellofemoral OA was found in 26 % 12 years after ACL reconstruction. Patellofemoral OA was associated with increased age, tibiofemoral OA, increased symptoms, and reduced function. It is of clinical importance to include functional and radiographic assessment of the patellofemoral joint in the examination of long-term consequences following an ACL reconstruction.
Norwegian Research Center for Active Rehabilitation (NAR), Oslo University Hospital, Hjelp24 NIMI Pb. 3843, Ullevaal Stadion, 0805, Oslo, Norway. oiestad@hotmail.com
Britt Elin
BE
Øiestad
Inger
I
Holm
Lars
L
Engebretsen
Arne Kristian
AK
Aune
Ragnhild
R
Gunderson
May Arna
MA
Risberg
D000328:Adult; D000367:Age Factors; D059549:Anterior Cruciate Ligament Reconstruction; D050376:Bone-Patellar Tendon-Bone Grafting; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging*; D010146:Pain / Q000209:etiology; D015995:Prevalence; D011859:Radiography; D012720:Severity of Illness Index