Even minor concomitant meniscus injuries are associated with posttraumatic osteoarthritis 15 years after anterior cruciate ligament reconstruction

IF 2.7 Q2 ORTHOPEDICS
Padmini Naga Karamchedu, Anika N. Breker, Meggin Q. Costa, Gary J. Badger, Paul D. Fadale, Michael J. Hulstyn, Robert M. Shalvoy, Holly C. Gil, Tannin A. Schmidt, Braden C. Fleming
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引用次数: 0

Abstract

Purpose

The aim was to evaluate the associations between baseline variables on the development of a symptomatic knee and imaging evidence of posttraumatic osteoarthritis (PTOA) 15 years after anterior cruciate ligament (ACL) surgery.

Methods

Data from 42 subjects enroled in the Tension Trial (NCT00434837) were evaluated at 15-year follow-up. Patient sex, meniscus injury, preoperative patient-reported outcomes (Knee Osteoarthritis Outcome Score [KOOS] function sports and recreation subscore [KOOS-sport], Short Form [SF]-36 mental health score), initial graft tension, and subsequent ACL surgery were evaluated to identify patients with a symptomatic knee using KOOS criteria (KOOS-Quality of life ≤87.5 and with at least two other subscores meeting the following thresholds (i.e., KOOS-Pain ≤86.1, KOOS-Symptoms ≤85.7, KOOS-Activities of daily living ≤86.8 and KOOS-Sport ≤85.0) and imaging evidence of PTOA (Osteoarthritis Research Society International [OARSI] radiographic score and Whole-Organ Magnetic Resonance Imaging Score [WORMS]) 15 years post-surgery using stepwise regression.

Results

The presence of a baseline meniscus tear was associated with a seven-fold increase (p = 0.03) in odds for a symptomatic knee at 15 years. A higher preoperative KOOS-sport was associated with a decreased occurrence of a symptomatic knee (p = 0.06). A higher KOOS-sport and the presence of a meniscus tear at baseline were associated with a greater OARSI difference score (p = 0.03 and p = 0.05, respectively) 15 years after ACL reconstruction. The presence of the baseline meniscus tear was associated with a higher WORMS (p = 0.07) 15 years after ACL reconstruction. All other variables were not significant predictors, though loss to follow-up was over 50%.

Conclusion

The presence of a minor meniscus injury was associated with a higher occurrence of a symptomatic knee and imaging evidence of posttraumatic osteoarthritis 15 years after ACL reconstruction. Furthermore, a higher preoperative KOOS-sport was associated with decreased occurrence of a symptomatic knee. Further studies are required to elucidate the associations of KOOS-sport with imaging PTOA.

Level of Evidence

Level IV.

Abstract Image

即使是轻微的半月板损伤也与前交叉韧带重建后15年的创伤后骨关节炎有关
目的评估前交叉韧带(ACL)手术后15年创伤后骨关节炎(pta)影像学证据与症状性膝关节发展的基线变量之间的关系。方法对42名参加张力试验(NCT00434837)的受试者进行15年随访。评估患者性别、半月板损伤、术前患者报告的结局(膝关节骨关节炎结局评分[oos]功能运动和娱乐亚评分[oos -sport]、Short Form [SF]-36心理健康评分)、初始移植物张力和随后的ACL手术,以根据oos标准(oos -生活质量≤87.5,且至少有两个其他亚评分满足以下阈值(即oos -疼痛≤86.1,oos -症状≤85.7,koos -日常生活活动≤86.8,koos -运动≤85.0),术后15年PTOA影像学证据(国际骨关节炎研究学会[OARSI] x线评分和全器官磁共振成像评分[WORMS])逐步回归。结果基线半月板撕裂的存在与15年时出现症状性膝关节的几率增加7倍相关(p = 0.03)。术前较高的KOOS-sport与症状性膝关节发生率降低相关(p = 0.06)。较高的KOOS-sport和基线时半月板撕裂的存在与ACL重建后15年较高的OARSI差异评分相关(p = 0.03和p = 0.05)。前交叉韧带重建15年后,半月板撕裂基线的存在与较高的WORMS相关(p = 0.07)。所有其他变量都不是显著的预测因子,尽管随访损失超过50%。结论:轻度半月板损伤与前交叉韧带重建15年后创伤后骨关节炎的症状性膝关节和影像学证据的发生率较高相关。此外,术前较高的KOOS-sport与症状性膝关节的发生率降低相关。需要进一步的研究来阐明KOOS-sport与成像pta的关系。证据等级四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Experimental Orthopaedics
Journal of Experimental Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
3.20
自引率
5.60%
发文量
114
审稿时长
13 weeks
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