The evolution of osteoarthritis in 103 patients with ACL reconstruction at 17 years follow-up

Published:August 29, 2006DOI:



      To evaluate the functional and radiological outcome of a bone–tendon–bone anterior cruciate ligament reconstruction, at long-term follow-up.


      A retrospective study of 148 patients, of which 103 were available for long-term follow-up. Complete functional and radiological evaluation (International Knee Documentation Committee scale) were performed in 89 out of the 103 patients [Anderson AF. Rating scales. In: Fu FH, Harner CD, Vince KG, (Eds.). Knee Surgery, Baltimore, Williams and Wilkins vol. 1, 1994; 12, pp. 275-296].


      The mean follow-up time was 17.4 years. Subjectively, 88% of the patients were very satisfied or satisfied. According to the IKDC score 55% had type A symptoms, 29% type B, 12% type C, and 4% type D. The IKDC ligament evaluation showed 14.9% type A, 44.8% type B, 35.8% type C, and 4.5% type D. At the review 22.7% had a narrowing <50% (C) and 4.7% a narrowing >50% (D). Onset of osteoarthritis showed an association with the status of the medial meniscus. Knees with a preserved (healthy or sutured) medial meniscus had a significantly (p<0.05) better radiological outcome. Among these, 9% had a joint space narrowing <50% (C) and 2% had a narrowing >50% (D). Medial meniscectomy, residual laxity, and femoral chondral defects were associated with osteoarthritis.


      The outcome of anterior cruciate ligament reconstruction plus extra-articular tenodesis is good in the very long term, particularly in knees with a preserved medial meniscus.


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        • Aglietti P.
        • Buzzi R.
        • Giron F.
        • Biddau F.
        • Sasso F.
        Arthroscopic assisted anterior cruciate ligament reconstruction with the central third patellar tendon. A 5–8 year follow-up.
        Knee Surg Sports Traumatol Arthrosc. 1997; 5: 138-144
        • Aglietti P.
        • Buzzi R.
        • D'andria S.
        • Zaccherotti F.
        Long-term study of anterior cruciate ligament reconstruction for chronic instability using the central one-third patellar tendon and a lateral extraarticular tenodesis.
        Am J Sports Med. 1992; 20: 38-45
      1. Anderson AF. Rating scales. In: Fu FH, Harner CD, Vince KG, (Eds.). Knee Surgery, Baltimore, Williams and Wilkins vol. 1, 1994; 12, pp. 275–296.

        • Anderson C.
        • Odensten M.
        • Gillquist G.
        Knee function after surgical or nonsurgical treatment of acute rupture of the anterior cruciate ligament: a randomized study with a long-term follow-up period.
        Clin Orthop Relat Res. 1991; 261: 255-263
        • Cameron M.
        • Buchgraber A.
        • Passler H.
        • Vogt M.
        • Thonar E.
        • Fu F.
        • et al.
        The natural history of the ACL deficient knee. Changes in synovial fluid cytokin and keratan sulfate concentration.
        Am J Sports Med. 1997; 6: 751-754
        • Chol C.
        • Ait Si Selmi T.
        • Chambat P.
        • Neyret P.
        Devenir à 17 ans de recul des ligamentoplasties du ligament croisé antérieur avec ménisque interne sain ou saturé.
        Rev Chir Orthop. 2002; 88: 157-162
        • Daniel D.M.
        • Stone M.L.
        • Dobson B.E.
        • Fithian D.C.
        • Rossman D.J.
        • Kaufman K.R.
        Fate of the ACL-injured patient. A prospective outcome study.
        Am J Sports Med. 1994; 22: 632-644
        • Dejour H.
        • Neyret P.
        • Boileau P.
        • Donell S.T.
        Anterior cruciate ligament reconstruction combined with valgus tibial osteotomy.
        Clin Orthop. 1994; 299: 220-228
        • Dejour H.
        • Walch G.
        • Chambat P.
        • et al.
        Active subluxation in extension. A new concept of study of the ACL deficient knee.
        Am J Knee Surg. 1988; 4: 204-211
        • Dejour H.
        • Walch G.
        • Neyret P.
        • Adeleine P.
        Résultats des laxités chroniques antérieures opérées. A propos de 251 cas revus avec un recul minimum de 3 ans.
        Rev Chir Orthop. 1988; 74: 622-636
        • Dejour H.
        • Dejour D.
        • Ait Si Selmi T.
        Laxités antérieures chroniques du genou traitées par greffe libre de tendon rotulien avec plastie latérale extra-articulaire.
        Rev Chir Orthop. 1999; 85: 777-789
        • Fithian D.C.
        • Paxton L.W.
        • Goltz D.H.
        Fate of the anterior cruciate ligament-injured knee.
        Orthop Clin North Am. 2002; 33: 621-636
        • Franklin J.L.
        • Rosenberg T.D.
        • Paulos L.E.
        • France E.P.
        Radiographic assessment of instability of the knee due to rupture of the anterior cruciate ligament. A quadriceps contraction technique.
        J Bone Joint Surg A. 1991; 73-A: 365-372
        • Hawkins R.J.
        • Misamore G.W.
        • Merritt T.R.
        Follow-up of the acute non-operated isolated ACL tear.
        Am J Sports Med. 1986; 14: 205-210
        • Jones K.
        Reconstruction of the anterior cruciate ligament. A technique using the central one-third patellar ligament.
        J Bone Joint Surg A. 1963; 45-A: 925-932
        • Kannus P.
        • Jarvinen M.
        Conservatively treated tears of the anterior cruciate ligament. Long-term results.
        J Bone Joint Surg A. 1987; 69-A: 1007-1012
        • Lemaire M.
        Résultats de la plastie extra-articulaire palliative de la rupture du ligament croisé antérieur.
        Rev Chir Orthop. 1983; 69: 278-282
        • Lerat J.L.
        • Chotel F.
        • Besse J.L.
        • Moyen B.
        • Binet G.
        • Craviari T.
        • et al.
        Les résultats après 10 à 16 ans du traitement de la laxité antérieure du genou par reconstruction du ligament croisé antérieur avec un greffe du tendon rotulien associée à une plastie extra-articulaire externe.
        Rev Chir Orthop. 1998; 1: 712-727
        • Lindeman
        La plastie des ligaments croisés par greffe tendineuse pédiculée.
        Z Orthop. 1979; : 316-334
        • Neyret P.
        • Walch G.
        • Dejour H.
        La méniscectomie interne intramurale selon la technique de A. Trillat. Résultat à long terme de 258 interventions.
        Rev Chir Orthop. 1988; 74: 637-646
        • O'Connor B.L.
        • Palmoski M.J.
        • Brandt K.D.
        Neurogenic acceleration of degenerative joint lesions.
        J Bone Joint Surg A. 1985; 67-A: 562-572
        • Rongieras F.
        • Ait Si Selmi T.
        • Neyret P.
        Histoire naturelle des ruptures du LCA.
        Index Traumatol Sport. 1998; 5: 67-73
        • Rosenberg T.D.
        • Paulos L.E.
        • Parker R.D.
        • Coward D.B.
        • Scott S.M.
        The forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee.
        J Bone Joint Surg A. 1988; 70-A: 1479-1482
        • Selva O.
        • Chambat P.
        • Telos W.G.
        • Casalonga D.
        • Bonnin M.
        Reconstruction du LCA avec un recul moyen supérieur à 10 ans.
        Rev Chir Orthop. 1997; 83: 14
        • Setton L.A.
        • Mow V.C.
        • Müller F.J.
        • Pita J.C.
        • Howell D.S.
        Mechanical properties of articular cartilage are significantly altered following transection of the anterior cruciate ligament.
        J Orthop Res. 1994; 12: 451-463
        • Shelbourne K.D.
        • Klootwyk T.E.
        • Wilckens J.H.
        • DE Carlos M.S.
        Ligament stability two to six years after anterior cruciate ligament reconstruction with autogenous patellar tendon graft and participation in accelerate rehabilitation program.
        Am J Sports Med. 1995; 23: 575-579