Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleLong-Term Results of Anterior Cruciate Ligament Reconstruction Using Bone–Patellar Tendon–Bone: An Analysis of the Factors Affecting the Development of Osteoarthritis
Section snippets
Participants and Preoperative Demographics
Between March 1997 and September 2001, 191 consecutive arthroscopic ACL reconstructions using BPTB autograft were performed at our institute. We excluded 45 of these patients because of either an associated ligament injury requiring surgery, prior knee surgery including meniscectomy, or bilateral ACL injuries. The inclusion criterion was primary ACL reconstruction using BPTB autograft with or without meniscal injury. Of the 146 patients included, 117 (80.1%) returned for clinical and radiologic
Clinical Evaluation
The mean preoperative Lysholm and HSS scores were 72.5 ± 12.5 (range, 27 to 90) and 78.1 ± 12.2 (range, 27 to 91), respectively. The mean postoperative Lysholm and HSS scores were 88.5 ± 7.6 (range, 65 to 100) and 87.4 ± 5.0 (range, 63 to 100), respectively. There was a significant increase in Lysholm score (P < .001) and HSS score (P < .001) at final follow-up. At follow-up, the mean IKDC 2000 subjective score and the mean Tegner score were 90.6 ± 10.3 (range, 51 to 100) and 6.2 ± 1.2 (range,
Discussion
This article reports the long-term clinical results of ACL reconstruction using BPTB autograft with particular attention to the development of knee OA. An analysis of the factors that might contribute to the progression of knee OA in the medial, lateral, and patellofemoral compartments separately by use of multiple logistic regression is also provided. Keays et al.12 evaluated the factors involved in the development of OA of the tibiofemoral joint and patellofemoral joint separately at 6 years
Conclusions
Arthroscopic ACL reconstruction with BPTB autograft showed satisfactory clinical results after a mean of 10.3 years. However, pain when walking on hard ground (38.4%) and numbness of the skin (37.6%) were reported. Moreover, the onset of OA appeared in over 40% of the patients. The onset of OA in the medial compartment was correlated with partial meniscectomy and sagittal tibial tunnel position, and the onset of OA in the lateral compartment was correlated with higher BMI.
References (36)
- et al.
Osteoarthritic changes after anterior cruciate ligament reconstruction using bone-patellar tendon-bone or hamstring tendon autografts: A retrospective, 7-year radiographic and clinical follow-up study
Arthroscopy
(2008) - et al.
Factors predicting functional and radiographic outcomes after arthroscopic partial meniscectomy: A review of the literature
Arthroscopy
(2005) - et al.
Fifteen-year follow-up of arthroscopic partial meniscectomy
Arthroscopy
(1997) - et al.
A comparative study of medial versus lateral arthroscopic partial meniscectomy on stable knees: 10-Year minimum follow-up
Arthroscopy
(2003) - et al.
Long-term results of non-operative treatment of anterior cruciate ligament injury
Knee
(2001) - et al.
Factors associated with radiographic osteoarthritis of the knee among community-dwelling Japanese women: The Hizen-Oshima Study
J Orthop Sci
(2011) - et al.
Mechanical determinants of osteoarthrosis
Semin Arthritis Rheum
(1991) - et al.
Patellar tendon graft harvesting using horizontal incisions for anterior cruciate ligament reconstruction
Arthroscopy
(1995) - et al.
Treatment of anterior cruciate ligament injuries, part I
Am J Sports Med
(2005) - et al.
Fate of the ACL-injured patientA prospective outcome study
Am J Sports Med
(1994)
Arthroscopic reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone autograft: A minimum 10-year follow-up
Am J Sports Med
Knee osteoarthritis after anterior cruciate ligament injury: A systematic review
Am J Sports Med
Long-term results after primary repair or non-surgical treatment of anterior cruciate ligament rupture: A randomized study with a 15-year follow-up
Scand J Med Sci Sports
Anterior and posterior cruciate ligament reconstruction in the new millennium: A global perspective
Knee Surg Sports Traumatol Arthrosc
Long-term outcome of endoscopic anterior cruciate ligament reconstruction with patellar tendon autograft: Minimum 13-year review
Am J Sports Med
ACL reconstruction using bone-patellar tendon-bone press-fit fixation: 10-Year clinical results
Knee Surg Sports Traumatol Arthrosc
Effects of meniscal and articular surface status on knee stability, function, and symptoms after anterior cruciate ligament reconstruction: A long-term prospective study
Am J Sports Med
Function, osteoarthritis and activity after ACL-rupture: 11 Years follow-up results of conservative versus reconstructive treatment
Knee Surg Sports Traumatol Arthrosc
Cited by (82)
Persistent underloading of patellofemoral joint following hamstring autograft ACL reconstruction is associated with cartilage health
2023, Osteoarthritis and CartilagePrognostic factors for tibiofemoral and patellofemoral osteoarthritis 32–37 years after anterior cruciate ligament injury managed with early surgical repair or rehabilitation alone
2021, Osteoarthritis and CartilageCitation Excerpt :Only two studies assessed prognostic factors for PFJ ROA after ACL injury1,11. These studies identified increased age as a prognostic factor for PFJ ROA at 12-year follow-up11 and no prognostic factors for PFJ ROA at a mean 10-years following ACL surgery12. Thus, the evidence assessing prognostic factors for ROA after ACL injury is limited, and many potential prognostic factors have not been investigated.
Pre-operative MRI measurements versus anthropometric data: Which is more accurate in predicting 4-stranded hamstring graft size in anterior cruciate ligament reconstruction?
2020, Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and TechnologyPrevalence of patellofemoral joint osteoarthritis after anterior cruciate ligament injury and associated risk factors: A systematic review
2020, Journal of Orthopaedic TranslationAnterior knee pain in ACL reconstruction with BPTB graft – Is it a myth? Comparative outcome analysis with hamstring graft in 1,250 patients
2020, Journal of OrthopaedicsCitation Excerpt :It remains the gold standard as far as mechanical stability and early return to high level sports is concerned.7 Most articles in the 1990s quote anterior knee pain (AKP) as the main drawback of BPTB autograft with an incidence of up to 40%.8–10 AKP following BPTB harvesting has several etiologies: more frequent bone-harvesting site pain, neuroma due to infrapatellar branch of medial saphenous nerve lesion and rarely patellar tendinopathy.11
The authors report that they have no conflicts of interest in the authorship and publication of this article.