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Twelve-Year Follow-up on Anterior Cruciate Ligament Reconstruction

Background: Although successful at restoring near normal laxity to the knee in the short term, anterior cruciate ligament reconstructions have not been shown to prevent the development of posttraumatic arthritis. Hypothesis: Bone bruises and articular cartilage injuries sustained at the time of init...

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Bibliographic Details
Published in:The American journal of sports medicine 2008-04, Vol.36 (4), p.671
Main Authors: Bryan T. Hanypsiak, Kurt P. Spindler, Christopher R. Rothrock, Gary J. Calabrese, Brad Richmond, Todd M. Herrenbruck, Richard D. Parker
Format: Article
Language:eng ; jpn
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Summary:Background: Although successful at restoring near normal laxity to the knee in the short term, anterior cruciate ligament reconstructions have not been shown to prevent the development of posttraumatic arthritis. Hypothesis: Bone bruises and articular cartilage injuries sustained at the time of initial injury (1991) would not resolve. Our secondary hypothesis was that the presence of a bone bruise or articular cartilage injury originally identified on magnetic resonance imaging would not be associated with long-term outcomes after anterior cruciate ligament reconstruction evaluated by the International Knee Documentation Committee questionnaire. Study Design: Cohort study (prognosis); Level of evidence, 1. Methods: We attempted to contact all patients from an original cohort (N = 54) for follow-up evaluation, which included repeat radiographs, magnetic resonance images, physical examination, and International Knee Documentation Committee questionnaire more than a decade postoperatively. Results: Forty-four patients (82% of the original cohort) returned for on-site follow-up. No patient with a bone bruise identified on original magnetic resonance imaging had one identified at 12-year follow-up. The mean ( ± SD) International Knee Documentation Committee score at follow-up with no bone bruise originally present was 70.6 ( ± 12.7) versus 70.0 ( ± 8.1) when a bone bruise was observed ( P > .05). No consistent association was observed between the presence of an initial articular cartilage lesion with a lesion on follow-up magnetic resonance images. The mean ( ± SD) International Knee Documentation Committee score at follow-up with no articular cartilage injury was 69.0 ( ± 11.9) versus 72.8 ( ± 12.0) with articular cartilage lesion ( P > .05). Conclusion: All bone bruises identified in our study with magnetic resonance imaging at the time of initial injury had resolved at 12-year follow-up. The presence of a bone bruise at the time of initial injury did not significantly alter the patient-oriented outcome by International Knee Documentation Committee after anterior cruciate ligament reconstruction. Additionally, articular cartilage abnormality on magnetic resonance imaging did not influence the International Knee Documentation Committee score. Keywords: ACL bone bruise MRI long-term prospective
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546508315468