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Knee Surg Sports Traumatol Arthrosc (2014) 22:10611069 DOI 10.1007/s00167-013-2466-3
KNEE
Long-term follow-up of ACL reconstruction with hamstring autograft
Jeff R. S. Leiter Robert Gourlay Sheila McRae
Nevin de Korompay Peter B. MacDonald
Received: 30 August 2012 / Accepted: 25 February 2013 / Published online: 18 April 2013 Springer-Verlag Berlin Heidelberg 2013
AbstractPurpose To investigate the differences in the incidence and severity of knee osteoarthritis (OA), joint space narrowing, knee laxity, and knee exion and extension strength between an anterior cruciate ligament (ACL)-reconstructed knee and the contralateral non-reconstructed limb.
Methods Retrospective case series of patients from a single surgeon that had an ACL reconstruction with a semitendinosus/gracilis autograft more than 12 years ago. Outcome measures included radiographic analysis, International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), KT-1000, Tegner Activity Level Scale, Lysholm Knee Score, ACL quality of life score (ACL-QOL) and knee exor/extensor strength.
Results Seventy-four patients consented and sixty-eight (43 male, 25 female) were included for analysis. Average age (SD) at the time of surgery was 31.2 (9.1) years. At follow-up of 14.6 (1.9) years, 9 % had re-ruptured their
ACL, whereas 5 % ruptured the contralateral ACL. Reconstructed knees had a greater incidence and severity of OA (P \ 0.01). Medial meniscus surgery was a strong predictor of OA. Seventy-ve per cent scored a normal or nearly normal knee on the IKDC. The mean Lysholm score was 75.8 % and Tegner Activity Level Scale scores decreased (P \ 0.001) from the time of surgery. Knee extension strength was greater in the contralateral knee at speeds of 60 /s (P = 0.014) and 150 /s (P = 0.012).
Conclusions Reconstructed knees have a greater incidence and severity of OA than non-reconstructed knees, which suggests degenerative changes are secondary to ACL rupture. Medial meniscus surgery is a strong predictor of OA. Despite this, 75 % of patients reported good outcomes.
Keywords ACL reconstruction Hamstring autograft
Muscle strength Osteoarthritis
Introduction
The anterior cruciate ligament (ACL) plays a critical role as a primary stabilizer of the human knee [5]. Rupture of the ACL is one of the most common knee injuries with an annual incidence in the United States of 80,000 tears and a cost of more than 1 billion dollars to the health care system [11]....