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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.
Subject(s)

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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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