title: No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years.
abstract: OBJECTIVE
  Aim of this study was to record and compare the functional and activity level as well as the manifestations of osteoarthritis after isolated ACL ruptures between patients with conservative treatment and ACL reconstruction with hamstrings tendon graft.
  
  
  METHODS
  Thirty-two patients diagnosed with ACL rupture were recorded. Clinical examination included the Tegner and Lysholm activity scale, the International Knee Documentation Committee Subjective Form and KT-1000 arthrometer. Narrowing of the medial and lateral joint spaces was assessed using the IKDC knee examination score.
  
  
  RESULTS
  Median follow-up was 10.3 years (range 10-11). Fifteen patients were conservatively treated (median age 33 years, range 25-39). Seventeen patients were operated (median age 31 years, range 20-36). There was significant difference between the mean values of IKDC scores in favour of the ACL-reconstruction group of patients, 86.8 (SD 6.5) versus 77.5 (SD 13.8), respectively (p = 0.04). The mean value of anteroposterior tibial translation was 1.5 mm (SD 0.2) for ACL-reconstruction group of patients, while the corresponding mean value for ACL-conservative group was 4.5 mm (SD 0.5), p = 0.03. Four patients in ACL-reconstruction group had radiological findings of grade C or D according to IKDC form. In ACL-conservative group, five patients presented similar signs (n.s.).
  
  
  CONCLUSIONS
  ACL reconstruction using hamstrings autograft resulted in better functional outcome and laxity measurements than ACL-conservative management. However, the incidence of radiological osteoarthritis was similar between the two groups and independent on the pre-operative grade of laxity and functional status of the patients. Equally, bone bruises were not found as a risk factor for the development of osteoarthritis after ACL rupture.
  
  
  METHODS
  Prospective randomized study, Level II.
authors: Orthopaedic Sports Medicine Clinic, 1-3 Distomou Street, Maroussi, 15125, Athens, Greece.
authors: Dimitrios
authors: D
authors: Tsoukas
authors: Royal Sussex County Hospital, Eastern Road, Brighton, East Sussex, BN2 5BE, UK.
authors: Vasilios
authors: V
authors: Fotopoulos
authors: Academic Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessaly, Larissa, Greece.
authors: Georgios
authors: G
authors: Basdekis
authors: , Flat 155F, Block D, The Plaza, Claypit Lane, Leeds, LS2 8BN, UK. kmakrid@yahoo.gr.|Centre Nollet (Teaching center - approved by ESSKA), Leeds Teaching Hospitals NHS Trust, Leeds, UK. kmakrid@yahoo.gr.
authors: Konstantinos G
authors: KG
authors: Makridis
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery / Q000628:therapy*; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D008297:Male; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011859:Radiography; D012421:Rupture / Q000601:surgery; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: ACL reconstruction; ACL-conservative treatment; Hamstring autograft; Osteoarthritis; Prospective study