Prevalence and Predictors of Patellofemoral Osteoarthritis after Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft
Clinics in Orthopedic Surgery
;
: 181-190, 2018.
Article
in English
| WPRIM
| ID: wpr-715564
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Osteoarthritis
/
Arthroscopy
/
Rehabilitation
/
Tendons
/
Cartilage
/
Logistic Models
/
Prevalence
/
Risk Factors
/
Follow-Up Studies
/
Anterior Cruciate Ligament
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Clinics in Orthopedic Surgery
Year:
2018
Type:
Article
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