Long-term results of anterior cruciate ligament reconstruction: a comparison with non-operative treatment with a follow-up of 17–20 years

Mihelic, Radovan; Jurdana, Hari; Jotanović, Zdravko; Madjarevic, Tomislav; Tudor, Anton

doi:10.1007/s00264-011-1206-x

Cited by 132 publications

(112 citation statements)

References 19 publications

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“…Milhelic et al published a report comparing operative versus conservative treatment and reported significant differences in OA rate between groups, with a significantly higher rate of OA with increased laxity. Furthermore, they reported the highest OA rate with concomitant menisectomy [18]. In this report, radiographic evaluation of OA revealed no signs of degenerative changes in 86.7% of patients on pretrauma assessment.…”

Section: Discussionmentioning

confidence: 70%

“…Further clinical evaluation criteria consisted of Tegener and Lysholm score [16,26]. Patients who scored >92 points were considered to have excellent results; scores between 91 and 76 points were good; scores <76 points were fair/poor according to the Lysholm score [18]. Clinical evaluation using both IKDC and Lysholm scores was performed 24 months after surgery and at the ten to 15-year followup.…”

Section: Assessmentsmentioning

confidence: 99%

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Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up

Struewer

Frangen

Ishaque

et al. 2011

International Orthopaedics (SICOT)

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Purpose The aim of this investigation was to study patientreported long-term clinical outcome, instrumental stablitity and prevalence of radiological osteoarthritis (OA) a minimum of ten years after isolated anterior cruciate ligament (ACL) reconstruction. Methods An average of 13.5 years after ACL reconstruction with bone-patellar tendon-bone (BTB) autograft, 73 patients were evaluated. Inclusion criteria consisted of an isolated ACL rupture and reconstruction with BPTB graft with no associated intra-articular lesions, in particular, cartilage alterations or meniscal lesions. Clinical assessment was performed using the International Knee Documentation Committee (IKDC) and Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT-1000™ arthrometer. Degree of degenerative changes and prevalence of OA were determined using the Kellgren-Lawrence scale. Results Mean follow-up was 13.5 years. Mean age was 43.8 years. About 75% of patients were graded A or B according to the IKDC score. The Lysholm score was 90.2± 4.8. Radiological assessment reported degenerative changes of grade II OA in 54.2% of patients. Prevalence of grades III or IV OA was found in 20%. The incidence of OA was significantly correlated with stability and function at long-term follow-up. Conclusion Arthroscopic ACL reconstruction using BPTB autograft resulted in a high degree of patient satisfaction and good clinical results on long-term follow-up. A higher degree of OA developed in 20% of patients and was significantly correlated with increased anterior laxity at long-term follow-up.

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Section: Discussionmentioning

confidence: 70%

Section: Assessmentsmentioning

confidence: 99%

Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up

Struewer

Frangen

Ishaque

et al. 2011

International Orthopaedics (SICOT)

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“…Mihelic et al [31] retrospectively studied outcome of 33 operated BTPB grafts with 17 to 20 year follow-up with 83% of patients having stable knees with normal or near normal IKDC grades and an IKDC score of 83.15, they do not however report re-rupture rates. Gerhard et al [32] report 16 year mean follow-up of 63 patients after BTPB ACL reconstruction with 84% returning to previous sporting levels with 78% normal or near normal IKDC grades and a KOOS score of 84.…”

Section: Graft Choicementioning

confidence: 99%

Anterior cruciate ligament reconstruction best practice: A review of graft choice

Shaerf

Pastides

Sarraf

et al. 2014

WJO

123

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There is much literature about differing grafts used in anterior cruciate ligament (ACL) reconstruction. Much of this is of poor quality and of a low evidence base. We review and summarise the literature looking at the four main classes of grafts used in ACL reconstruction; bone-patella tendon-bone, hamstrings, allograft and synthetic grafts. Each graft has the evidence for its use reviewed and then compared, where possible, to the others. We conclude that although there is no clear "best" graft, there are clear differences between the differing graft choices. Surgeon's need to be aware of the evidence behind these differences, in order to have appropriate discussions with their patients, so as to come to an informed choice of graft type to best suit each individual patient and their requirements.

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“…The KANON study (the Knee, Anterior cruciate ligament, NON-surgical versus surgical treatment) [89] found no difference in muscle power and functional tests between strength training with surgical intervention when compared to conservative management strategies at 2-5 years of followup. However, the development of osteoarthritis in the knee was reported to be increased in non-operative ACL-injured patient [90] compared a delayed progression in patients with ACLR after 15-20 years of followup [91].…”

Section: Decision Making Prior To Surgerymentioning

confidence: 99%

Prehabilitation: The Void in the Management of Anterior Cruciate Ligament Injuries—A Clinical Review

Shaarani

Moyna

Moran

et al. 2012

ISRN Rehabilitation

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The rehabilitation of patients undergoing anterior cruciate ligament (ACL) reconstruction requires symmetry in bilateral quadriceps strength and adequate proprioception capabilities prior to return to preoperative level of activity or sport. This is the limiting factor and can delay the time that patients can return to play. There is little literature on pre-operative physiotherapy or prehabilitation of patient with ACL injury. This paper discusses the anatomy, biomechanics, surgical decision making, and the current knowledge of preoperative training or "prehabilitation" in patients awaiting ACL reconstruction.

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Long-term results of anterior cruciate ligament reconstruction: a comparison with non-operative treatment with a follow-up of 17–20 years

Abstract: We can conclude that 94% of patients who underwent ACL reconstruction had stable knees after 15-20 years and there was a significantly lower percentage of osteoarthritis in comparison to conservatively treated patients.

Cited by 132 publications

References 19 publications

Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up

Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up

Anterior cruciate ligament reconstruction best practice: A review of graft choice

Prehabilitation: The Void in the Management of Anterior Cruciate Ligament Injuries—A Clinical Review

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