title: Cruciate ligament reconstruction and risk of knee osteoarthritis: the association between cruciate ligament injury and post-traumatic osteoarthritis. a population based nationwide study in Sweden, 1987-2009.
abstract: OBJECTIVE
  To study the association between Cruciate Ligament (CL) injury and development of post-traumatic osteoarthritis in the knee in patients treated operatively with CL reconstruction compared with patients treated non-operatively.
  
  
  METHODS
  Population based cohort study; level of evidence II-2.
  
  
  METHODS
  Sweden, 1987-2009.
  
  
  METHODS
  All patients aged between 15-60 years being diagnosed and registered with a CL injury in The National Swedish Patient Register between 1987 and 2009.
  
  
  METHODS
  Knee osteoarthritis.
  
  
  RESULTS
  A total of 64,614 patients diagnosed with CL injury during 1987 to 2009 in Sweden were included in the study. Seven percent of the patients were diagnosed with knee OA in specialized healthcare during the follow-up (mean 9 years). Stratified analysis by follow-up showed that while those with shorter follow-up had a non-significant difference in risk (0.99, 95%CI 0.90-1.09 for follow-up less than five years compared with the non-operated cohort), those with longer follow-up had an increased risk of knee OA after CL reconstruction (HR = 1.42, 95%CI 1.27-1.58 for follow-up more than ten years compared with non-operated cohort). The risk to develop OA was not affected by sex.
  
  
  CONCLUSIONS
  CL reconstructive surgery does not seem to have a protective effect on long term OA in either men or women.
authors.affiliation: Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Richard
authors.initials: R
authors.lastname: Nordenvall
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Center for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Bahmanyar
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Adami
authors.affiliation: Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden; Department of Orthopedics and Trauma Surgery, University Hospital of Tampere, Tampere, Finland.
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
authors.affiliation: Division of Orthopedics and Biotechnology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Li
authors.initials: L
authors.lastname: Felländer-Tsai
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D015331:Cohort Studies; D005500:Follow-Up Studies; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology* / Q000209:etiology* / Q000266:history; D011159:Population Surveillance; D016119:Posterior Cruciate Ligament / Q000293:injuries / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012042:Registries; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D000070600:Tibial Meniscus Injuries; D055815:Young Adult