Article

In cases of chronic anterior laxity, reconstruction of the anterior
cruciate ligament (ACL) can slow the development of osteoarthritis. This study
was conducted to determine the overall prevalence of osteoarthritis and to
identify the risk factors after ACL reconstruction.
HYPOTHESIS: Meniscus tears,
time from injury to surgery, body mass index (BMI), residual laxity, and
cartilage lesions influence the progression towards osteoarthritis.
METHODS: This multicenter, retrospective study on the outcome of cruciate
ligaments at 12 years of follow-up was conducted within the 2014 SOFCOT
Symposium. The cohort included 675 arthroscopic reconstructions of the ACL from
January 2002 to December 2003. The clinical evaluation included the objective and
subjective IKDC score. Osteoarthritis was analyzed on 589 knee X-rays according
to the IKDC classification. The predictive factors of osteoarthritis development
studied were age, gender, BMI, time from injury to surgery, activity level,
medial or lateral meniscectomy, type of graft, medial or lateral chondropathy,
tunnel positioning, and residual laxity. Univariate and multivariate analyses
with logistic regression were performed. RESULTS: The mean follow-up was
11.9+/-0.8 years. The subjective IKDC score was 83.7+/-13. At 12 years, the rate
of moderate to severe osteoarthritis l (IKDCC or D) was 19% (16% medial
tibiofemoral osteoarthritis, 4% lateral tibiofemoral osteoarthritis, and 2%
patellofemoral osteoarthritis). The prognostic factors were age at surgery
greater than 34 years (P<0.05), cartilage lesions at surgery (P<0.05), medial or
lateral meniscectomy (P<0.05), and residual laxity (P<0.05). CONCLUSIONS: This
large-scale study identified risk factors for osteoarthritis that should improve
the information provided to patients on long-term progression after ACL reconstruction.
Retrospective cohort study, level IV.
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Langue : ANGLAIS