Risk factors for radiographic joint space narrowing and patient reported outcomes of post-traumatic osteoarthritis after ACL reconstruction: Data from the MOON cohort.
Risk factors for radiographic joint space narrowing and patient reported outcomes of post-traumatic osteoarthritis after ACL reconstruction: Data from the MOON cohort.
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DOI：
10.1002/jor.23557
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Spindler KP
中科院分区：
文献类型：
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作者：
Jones MH;Spindler KP
多中心骨科预后网络（MOON）是美国国立卫生研究院（nih）资助的一项前瞻性纵向队列研究，研究对象为3500多名接受了前交叉韧带重建（ACLR）手术的患者，由7个学术医疗中心的14名运动医学外科医生进行。患者报告结果问卷（PRO’s）在基线和手术后多个时间点完成，并对患者进行嵌套队列x线片检查，以评估关节间隙变化的发展。我们回顾了导致患者报告结果恶化的危险因素，创伤后骨关节炎（PTOA）临床显著症状的预测因素，以及与影像学上关节间隙变窄相关的因素。基线PRO对随访评分具有高度预测性。2岁和6岁时PRO较差的相关因素包括女性、较高的BMI、吸烟、受教育程度低、同种异体移植、内侧半月板切除术或修复以及软骨损伤。部分外侧半月板切除术出人意料地与更好的PRO相关。与2年和6年临床显著性上睑下垂症状相关的因素包括后续手术、半月板病理和软骨损伤。与内侧间室关节间隙宽度变窄相关的因素包括内侧半月板切除术、内侧半月板修复和年龄增加。与对侧正常膝关节相比，ACLR膝关节的内侧关节间隙宽度略宽。未来的研究将评估PRO和10年随访的x线片。
The Multicenter Orthopaedic Outcomes Network (MOON) is an NIH-funded prospective, longitudinal cohort of over 3500 patients who have undergone anterior cruciate ligament reconstruction (ACLR) by 14 sports medicine surgeons at 7 academic medical centers. Patient reported outcome questionnaires (PRO’s) are completed at baseline and multiple timepoints after surgery, and a nested cohort of patients return for radiographs to assess the development of joint space changes. We review the risk factors for worse patient reported outcomes, the predictors of clinically significant symptoms of post-traumatic osteoarthritis (PTOA), and the factors associated with more radiographic joint space narrowing. Baseline PRO’s were highly predictive of follow-up scores. Factors associated with worse PRO’s at 2 and 6 years included female sex, higher BMI, smoking, less education, allograft, medial meniscectomy or repair, and chondral injury. Partial lateral meniscectomy was unexpectedly associated with better PRO’s. Factors associated with clinically significant symptoms of PTOA at 2 and 6 years included subsequent surgery, meniscal pathology, and chondral injury. Factors associated with narrower medial compartment joint space width included medial meniscectomy, medial meniscus repair, and increased age. Medial joint space width was slightly wider overall for the ACLR knees compared to the contralateral normal knees. Future studies will evaluate PRO’s and radiographs at 10 year follow-up.