Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury

Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury
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DOI:
10.1177/0363546508316770
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发表时间:
2008-09-01
影响因子:
4.8
通讯作者:
Dahlberg, Leif E.
Dahlberg, Leif E.
中科院分区:
医学1区
文献类型:
--
作者:
Neuman, Paul;Englund, Martin;Dahlberg, Leif E.

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背景资料:关于前交叉韧带(ACL)损伤后骨关节炎(OA)、相关关节损伤、关节切除术以及非手术治疗患者的相关措施的发生率,在文献中没有很好的描述。假设:ACL损伤患者在不进行ACL重建的情况下,胫股OA的发生率较低,膝关节功能良好。研究设计:队列研究方法:对100例急性完全性ACL损伤患者进行15年的连续观察。所有患者均接受活动改良治疗,未进行ACL重建。为了改善功能稳定性,在受伤后早期开始监督物理治疗。患者进行了检查,采用前后负重摄影。膝关节损伤和骨关节炎结局评分(KOOS)被用来量化膝关节相关症状和膝关节functions.Results:79例患者同意接受放射学检查,93例完成了KOOS问卷。13名患者(16%)(均在35名膝关节全切除术患者中)发生放射学胫股OA。与此相反,其余未行髌骨切除和X线检查的膝关节均未发生OA(n = 44)(P
Background: The occurrence of osteoarthritis (OA), associated meniscal injuries, meniscectomy, and patient-related measures for patients treated nonoperatively after anterior cruciate ligament (ACL) injuries have not been well described in the literature in terms of natural history.Hypothesis: Patients with ACL injury can achieve a low occurrence of tibiofemoral OA and good knee function when treated without ACL reconstruction.Study Design: Cohort study (prognosis); Level of evidence, 2.Methods: One hundred consecutive patients with an acute, complete ACL injury were observed for 15 years. All patients were primarily treated with activity modification and without ACL reconstruction. To achieve improved functional stability, supervised physical therapy was initiated early after injury. The patients were examined using anteroposterior weightbearing radiography. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used to quantify knee-related symptoms and knee function.Results: Seventy-nine patients consented to radiographic examination and 93 completed the KOOS questionnaire. Thirteen patients (16%), all of whom were among the 35 patients whose knees were meniscectomized, developed radiographic tibiofemoral OA. In contrast, none of the remaining nonmeniscectomized and radiographed knees developed OA (n = 44) (P