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Osteoarthritis of the knee after ACL reconstruction

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Summary

One hundred and fourteen knees with deficiency of the anterior cruciate ligament (ACL) which had undergone reconstruction of the ligament using semitendinosus and gracilis were reviewed at a mean of 61 months after operation. Radiological and clinical evaluation was undertaken. A significant correlation was found between the number of meniscectomies performed in acute cases and those undertaken on the chronic knee. There was also significant correlation between meniscectomy and the Fairbank grading of degenerative changes seen on the radiographs. There was no correlation between the clinical results, residual laxity and the development of osteoarthritis. In ACL deficient knees with irreparable meniscal tears, or in which meniscectomy had been undertaken, the development of osteoarthritis seemed independent of the degree of stability, but in such knees with no meniscal tear or meniscal repair, reconstruction appeared to save the menisci and preserve the joint.

Résumé

Les auteurs ont revu, avec un recul de 61 mois, 114 genoux opérés pour reconstruction du ligament croisé antérieur (LCA) au moyen du demitendineux et du droit interne. Une évaluation clinique et radiologique a été effectuée. L'analyse des radiographies en charge a montré une corrélation significative entre l'existence de signes de dégradation articulaire et les méniscectomies effectuées dans le même temps que la reconstruction ligamentaire. Une bonne corrélation a été également retrouvée entre le niveau sportif post-opératoire et la présence de ces signes. Aucune corrélation n'a été trouvée entre l'évolution de l'arthrose et le résultat clinique, en ce qui concerne la stabilité. En conclusion, dans les cas comportant une lésion irréparable des ménisques et une méniscectomie, la reconstruction du LCA ne semble pas capable de prévenir le développement de l'arthrose post-traumatique.

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Ferretti, A., Conteduca, F., De Carli, A. et al. Osteoarthritis of the knee after ACL reconstruction. International Orthopaedics 15, 367–371 (1991). https://doi.org/10.1007/BF00186881

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