Prevalence and Predictors of Patellofemoral Osteoarthritis after Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft.
10.4055/cios.2018.10.2.181
- Author:
Dhong Won LEE
1
;
Cheol Hynn YEOM
;
Du Han KIM
;
Tae Min KIM
;
Jin Goo KIM
Author Information
1. Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea. boram107@hanmail.net
- Publication Type:Original Article
- Keywords:
Anterior cruciate ligament reconstruction;
Patellofemoral osteoarthritis;
Meniscectomy;
Knee extension;
Risk factors
- MeSH:
Anterior Cruciate Ligament Reconstruction*;
Anterior Cruciate Ligament*;
Arthroscopy;
Autografts*;
Cartilage;
Classification;
Follow-Up Studies;
Humans;
Logistic Models;
Osteoarthritis*;
Prevalence*;
Rehabilitation;
Risk Factors;
Tendons*
- From:Clinics in Orthopedic Surgery
2018;10(2):181-190
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The present study aimed to evaluate the prevalence of patellofemoral osteoarthritis (PFOA) and identify the factors that affect PFOA development after single-bundle anterior cruciate ligament (ACL) reconstruction with hamstring autograft. We hypothesized that detecting these factors could be helpful in establishment of a rehabilitation strategy to focus on the modifiable factors. METHODS: Of the 324 patients who underwent primary ACL reconstruction between January 2010 and June 2013, 92 patients who were available for follow-up for a minimum of 36 months after the surgery and underwent second-look arthroscopy were enrolled. Subjective assessments and clinical outcome evaluation were conducted. Arthroscopic cartilage evaluation was done using the Outerbridge classification. Univariable and multivariable logistic regression analyses were used. RESULTS: Ninety-two patients were evaluated at an average of 38.9 ± 5.4 months of follow-up. PFOA above grade 2 was observed in 19 patients (20.7%) at the second-look arthroscopy. Of them, three patients with pre-existing PFOA (3.3%) showed progression of the Outerbridge grade, and 16 (17.4%) had newly developed PFOA. According to the multivariable logistic regression analysis, isokinetic extensor deficit at 60°/sec at the last follow-up (odds ratio [OR], 2.193; 95% confidence interval [CI], 1.081 to 12.439; p = 0.031), age at primary surgery (OR, 1.118; 95% CI, 1.019 to 1.227; p = 0.018), and concurrent meniscectomy at primary surgery (OR, 0.091; 95% CI, 1.012 to 1.177; p = 0.023) were the significant predictors of PFOA development. CONCLUSIONS: Significant predictors of PFOA after ACL reconstruction with hamstring autograft were decreased quadriceps strength at last follow-up, increased age, and concurrent meniscectomy at primary surgery. Quadriceps weakness as a modifiable factor should be considered in the establishment of a rehabilitation strategy to prevent PFOA after ACL reconstruction, especially in older age.
