Osteoarthritis after anterior cruciate ligament reconstruction using a patellar tendon autograft

Abstract

We studied 58 knees that underwent anterior cruciate ligament (ACL) reconstruction using a patella tendon autograft. The mean age at reconstruction was 30.4 (18-58) years, and the average follow-up was 11.2 (8.6-13.8) years. The presence of osteoarthritis was assessed radiographically using Kellgren and Lawrence's classification. Osteoarthritis was detected in the medial compartment in 25 cases and in the lateral compartment in 14 cases. Significant independent predictors of osteoarthritis were: accompanying meniscal injury [odds ratio (OR) 9.19), p<0.001], an interval of more than 6 months from injury to reconstruction (OR 4.77, p=0.021), and age more than 25 years at reconstruction (OR 3.37, p=0.034). However, no statistically significant correlation was found between the development of osteoarthritis and clinical outcome or radiological stability.

Fig. 1

Antero-posterior radiographs taken 10 years after reconstruction showing no evidence of degenerative osteoarthritis in either knee. At the time of reconstruction, the patient was 20 years old and had no risk factors such as accompanying meniscal injury or an extended time between injury and reconstruction

Fig. 2

Antero-posterior radiographs taken 12 years after reconstruction showing evidence of grade II osteoarthritis on the medial and patello-femoral compartments of the reconstructed knee (right). This male patient had two risk factors, namely, an older age at the time of reconstruction (33 years old) and an extended time from injury to reconstruction (12 years)

Fig. 3

Antero-posterior radiographs taken 13.7 years after reconstruction showing evidence of grade III osteoarthritis on the medial compartment of the reconstructed knee (right). This patient had three risk factors: an older age at the time of reconstruction (30 years old), a long time from injury to reconstruction (7 years), and an accompanying medial meniscus injury