Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up

Streich, N.; Zimmermann, David; Bode, Gerrit; Schmitt, Holger

doi:10.1007/s00264-010-1174-6

Cited by 93 publications

(93 citation statements)

References 25 publications

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“…In a prospective study on 63 patients, Wu et al reported similar results from patients with ACL rupture and reconstruction surgery [29]. They also reported a significant deterioration in clinical condition with associated meniscectomy or imperfect control of laxity and They found significant differences in mean IKDC score of the two groups and reported significant differences in the rate of OA in both groups, with a significantly higher rate of OA in conservative treatment [17,25]. Lysholm and Tegener scores showed deterioration of patents' clinical constitution in comparison with results two years after ACL reconstruction.…”

Section: Discussionsupporting

confidence: 57%

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: Discussionsupporting

confidence: 57%

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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“…However, recent evidence suggests that these procedures do not dramatically improve long-term patient outcomes. [2][3][4][5] Tissue engineering is an alternative approach that seeks to promote functional healing through the design and implantation of constructs containing stem/progenitor cells seeded in a biocompatible scaffold.…”

Section: Introductionmentioning

confidence: 99%

Fibrin Gels Exhibit Improved Biological, Structural, and Mechanical Properties Compared with Collagen Gels in Cell-Based Tendon Tissue-Engineered Constructs

Breidenbach

Dyment

et al. 2015

Tissue Engineering Part A

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The prevalence of tendon and ligament injuries and inadequacies of current treatments is driving the need for alternative strategies such as tissue engineering. Fibrin and collagen biopolymers have been popular materials for creating tissue-engineered constructs (TECs), as they exhibit advantages of biocompatibility and flexibility in construct design. Unfortunately, a few studies have directly compared these materials for tendon and ligament applications. Therefore, this study aims at determining how collagen versus fibrin hydrogels affect the biological, structural, and mechanical properties of TECs during formation in vitro. Our findings show that tendon and ligament progenitor cells seeded in fibrin constructs exhibit improved tenogenic gene expression patterns compared with their collagen-based counterparts for approximately 14 days in culture. Fibrin-based constructs also exhibit improved cell-derived collagen alignment, increased linear modulus (2.2-fold greater) compared with collagen-based constructs. Cyclic tensile loading, which promotes the maturation of tendon constructs in a previous work, exhibits a material-dependent effect in this study. Fibrin constructs show trending reductions in mechanical, biological, and structural properties, whereas collagen constructs only show improved tenogenic expression in the presence of mechanical stimulation. These findings highlight that components of the mechanical stimulus (e.g., strain amplitude or time of initiation) need to be tailored to the material and cell type. Given the improvements in tenogenic expression, extracellular matrix organization, and material properties during static culture, in vitro findings presented here suggest that fibrin-based constructs may be a more suitable alternative to collagen-based constructs for tissue-engineered tendon/ligament repair.

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“…ACL dysfunction is considered to be one of the major risk factors of knee OA [1,9,14,15,17,18,29,30]. When the ACL is injured, not only tibio-femoral OA, but also PF-OA progression is seen in long-term follow up [11,23,30].…”

Section: Discussionmentioning

confidence: 99%

“…Even after ACL reconstruction, PF-OA progression has been reported in short to mid-term follow-up periods [10,11]. However, many reports of PF-OA after ACL tear or reconstruction include follow-up data of less than 20 years [10][11][12][13][14][15][16][17][18], and the evaluation of PF-OA in elderly subjects without ACL function has not been well investigated. Moreover, although tibio-femoral OA changes have been well described in previous reports [19][20][21][22], reports on the morphology of PF-OA are rare [5,6,23].…”

Section: Introductionmentioning

confidence: 99%

Anterior cruciate ligament deterioration correlates with patella osteoarthritis

Iriuchishima¹,

Ryu

Aizawa

et al. 2013

International Orthopaedics (SICOT)

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Purpose The correlation between anterior cruciate ligament (ACL) condition and patella osteoarthritic (OA) changes has not been well reported. The aim of this study was to reveal the correlation between ACL deterioration and the morphology of OA changes in the patella. The hypothesis was that significant correlation between ACL deterioration and patella OA morphology would be revealed in this study. Methods Two hundred ninety-one cadaveric knees from 151 cadavers were included in this study with a median age of 83 years (54-98). Knees were opened with a sub-vastus approach and the ACL condition was classified as intact or deteriorated. Patella OA lesions were classified using Han's method: type 1, no or minimal lesion; type 2, medial facet lesion without involvement of the ridge; type 3, lateral facet lesion without involvement of the ridge; type 4, lesion involving the ridge only; type 5, medial facet lesion with involvement of the ridge; type 6, lateral facet lesion with involvement of the ridge; and type 7, global lesion. OA depth evaluation was performed following Outerbridge's classification. Statistical analysis of the collected data was performed using generalized estimating equations (GEE). Results The ACL was intact in 277 knees and deteriorated in 14 knees. Patella OA lesions were observed as follows: type 1, 29 %; type 2, 15 %; type 3, 2 %; type 4, 12 %; type 5, 18 %; type 6, 2 %; and type 7, 22 %. Outerbridge's classification of over grade 2 OA depth was observed in 73.5 % of subjects. When patella OA was divided into types 1-4 and types 5-7, ACL deterioration was correlated with the occurrence of type 5-7 patella OA [OR 6.44, 95%CI 2.27-18.25, p =0.000]. When patella OA was divided into types 1-6 and type 7, ACL deterioration was correlated with the occurrence of type 7 patella OA [OR 6.02, p =0.000]. When patella OA depth was divided into grades 1-3 and grade 4, ACL deterioration was highly correlated with the occurrence of grade 4 patella OA [OR 9.31, p =0.025]. Conclusion ACL deterioration is a strong risk factor of wider and deeper OA changes in the patella. For clinical relevance, subjects with ACL tear should be aware of the progression of patella OA.

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Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up

Cited by 93 publications

References 25 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

Fibrin Gels Exhibit Improved Biological, Structural, and Mechanical Properties Compared with Collagen Gels in Cell-Based Tendon Tissue-Engineered Constructs

Anterior cruciate ligament deterioration correlates with patella osteoarthritis

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