scholarly journals A Matched-pair Comparison of Patient-reported Outcomes following Primary ACL Reconstruction with Hamstring Autograft vs Hybrid Graft

2016 ◽  
Vol 32 (6) ◽  
pp. e6
Author(s):  
Matthew Kraeutler ◽  
Seong Kim ◽  
Colin Brown ◽  
Darby Houck ◽  
Brian Domby ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Matched Pair ◽  
Hamstring Autograft ◽  
Pair Comparison ◽  
Patient Reported ◽  
Primary Acl Reconstruction

scholarly journals Outcomes Following ACL and Grade III MCL Injuries

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0012 ◽  
Author(s):  
Robert W. Westermann ◽  
Kurt P. Spindler ◽  
Carolyn M. Hettrich ◽  
Brian R. Wolf
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Operative Management ◽  
Lower Activity ◽  
Study Enrollment ◽  
Patient Reported ◽  
Prospective Longitudinal ◽  
Primary Acl Reconstruction ◽  
Grade Iii

Objectives: Complete disruptions of the medial collateral ligament (MCL) are rare, but do occur with anterior cruciate ligament (ACL) tears. Complete ACL/MCL injuries may be managed with ACL reconstruction and either conservative or operative treatment of the MCL. MCL tear location has also been associated with outcome. We hypothesized that outcomes would be best with acute surgery and worse with proximal MCL tears.We also hypothesized that operative management of MCL injuries would not influence outcome. Methods: Patients enrolled in a multicenter prospective longitudinal cohort who underwent unilateral primary ACL reconstruction between 2002-2008 and who had 2-year follow-up were evaluated. Patients with concomitant grade III MCL injuries treated either operatively or non-operatively were identified. Concurrent injuries (to meniscus or articular cartilage) and subsequent surgeries were documented. Comparisons of surgical chronicity (before and after 30 days from injury) and MCL tear location (femoral or tibial) were performed. Patient reported outcomes (KOOS, IKDC and Marx activity scores) were measured at the time of ACL reconstruction and at 2-year follow-up. Results: Initially, 3028 patients were identified to have undergone primary ACL reconstruction in the cohort during the identified time frame, with 2586 patients completing 2-year follow-up (85%). Complete MCL tears were documented in 1.1% (27/2586) of the cohort: 16 operatively managed patients and 11 conservatively treated MCLs during ACL reconstruction. Concurrent articular pathology was similar between groups. Clinically important differences were seen in baseline KOOS (all subscales) and IKDC scores, with lower scores seen in patients who underwent operative MCL treatment. Reoperation for arthrofibrosis was higher after operative repair of the MCL (19%) versus nonoperative treatment (9%). At 2 years the non-operative MCL cohort maintained significantly better KOOS Sports Rec (88.2 versus 74.4), KOOS QOL (81.3 versus 68.4), and IKDC (87.6 versus 76.0) scores compared to the MCL surgery group. Marx activity scores were equal between groups at the time of study enrollment, however patients who underwent operative MCL management had lower activity scores at 2 years (6.5 versus 10.7). Tibial-sided MCL injuries were associated with worse baseline outcomes compared with femoral-sided MCL injuries in terms of KOOS ADL, Sports Rec, and QOL subscales, but these differences were resolved by 2 years. Surgical chronicity did not influence 2-year outcome. Conclusion: Complete and combined ACL/MCL injuries are rare. Both operative and nonoperative management of MCL tears in our cohort demonstrated clinical improvements between study enrollment and 2-year follow-up. MCL surgery during ACL reconstruction was associated with more frequent stiffness, worse patient-reported outcomes and lower activity at 2 years. There may be a subset of patients with severe combined ACL and medial knee injuries that may benefit from operative management, however, that patient population has yet to be defined.

scholarly journals Association Between Psychological Readiness, Patient Reported Outcomes and Return to Sports Following Primary Anterior Cruciate Ligament Reconstruction: Readiness Outcomes Affecting Return-to-Sport (ROAR)

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0048
Author(s):  
Jessica Traver ◽  
Melissa Christino ◽  
Ryan Coene ◽  
Kathryn Williams ◽  
Dai Sugimoto ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Return To Sport ◽  
Functional Testing ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction

Objectives: Successful return-to-sport (RTS) following anterior cruciate ligament (ACL) reconstruction can be affected by several variables, including a patient’s physical and psychological states throughout the rehabilitation process. Several studies have reported patients with increased fear-of-reinjury may be at risk for secondary injury following ACL reconstruction. The primary objective was to compare the relationship between ACL-RSI, Pedi-IKDC, Pedi-FABS, and PROMIS-Psychological Stress Experiences (PSE) across various age groups and graft types between patients undergoing primary ACL reconstruction at the 6 month post-operative visit. Secondary outcome was timing of RTS clearance. Methods: Patients prospectively enrolled were 8-30 years old who underwent primary ACL reconstruction at a large pediatric academic sports medicine center from August 2018 until February 2019. They were evaluated at their 6 month follow-up appointment and underwent functional RTS testing. Patients were divided into 3 groups based on their age: Pre-Adolescent (ages 8-14), Adolescent (ages 15-18), and Adult (ages >18) to reflect their psychological/emotional maturity. Demographic information, time to RTS clearance, and functional testing measurements were collected. Analysis included one-way ANOVA and Kruskal-Wallis tests. Results: A total of 100 patients were included in the study (57 males, 43 females; mean age, 17.3±2.9 years). RTS functional testing was performed at a mean of 6.3±0.7 months after primary ACL reconstruction. The 3 age groups consisted of Pre-Adolescent (n=13), Adolescent (n=62), and Adult (n=25). The graft types were HS (n=79), BTB (n=14), ITB (n=7). Mean ACL-RSI scores were significantly different among age groups (Pre-Adolescent 80.3±10.6, Adolescent 60.4±23.3, Adult 54.3±21.3; p=0.003) and graft type (HS 61.2±22.0, BTB 52.9±26.4, ITB 82.1±9.7; p=0.019). Scores were significantly different among the 3 age groups for IKDC (Pre-Adolescent 85.4±12.1, Adolescent 77.5±13.8, Adult 61.0±8.4; p<0.001). Scores were not significantly different among the three age groups for Pedi-FABS (Pre-Adolescent 24.9±5.4, Adolescent 23.6±8.1, Adult 20.6±9.2; p=0.212). The mean PROMIS-PSE t-scores were significantly different among the age groups (Pre-Adolescent 45.8±8.6, Adolescent 52.0±7.2, Adult 53.8±8.1; p=0.009) and graft type (HS 52.4±7.7, BTB 52.7±6.6, ITB 40.9±4.9; p<0.001). There were no significant differences for average timing of RTS clearance among the 3 age groups (Pre-Adolescent 8.5±1.5 months, Adolescent 8.0±1.3 months, Adult 8.1±1.2 months; p=0.618). Conclusion: This study suggests that psychological profiles and subjective perceptions of knee function following ACL reconstruction may vary in young patients of different ages. Pre-adolescent patients had better scores on all patient reported outcomes compared to adolescent and adult patients. Age-related differences in patient reported outcomes should be considered when evaluating young athletes. [Figure: see text]

scholarly journals ASSOCIATION BETWEEN PSYCHOLOGICAL READINESS, PATIENT REPORTED OUTCOMES, AND RETURN-TO-SPORT FOLLOWING PRIMARY ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: READINESS OUTCOMES AFFECTING RETURN-TO-SPORT (ROAR)

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0022
Author(s):  
Jessica L. Traver ◽  
Melissa A. Christino ◽  
Ryan Coene ◽  
Tyler Schaeffer ◽  
Kathryn Williams ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Young Patients ◽  
Return To Sport ◽  
Functional Testing ◽  
Patient Reported ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction

Background: Successful return-to-sport (RTS) following anterior cruciate ligament (ACL) reconstruction can be affected by several variables, including a patient’s physical and psychological state throughout the rehabilitation process. Several studies have reported patients with increased fear-of-reinjury may be at risk for secondary injury following ACL reconstruction. Purpose: The primary objective was to prospectively compare the relationship between ACL-RSI, Pedi-IKDC, Pedi-FABS, and PROMIS-Psychological Stress Experiences (PSE) across various age groups and graft types between patients undergoing primary ACL reconstruction at the 6-month post-operative visit. Secondary outcomes were timing of RTS clearance and performance on functional RTS testing measures. Methods: Patients enrolled were 8-30 years old who underwent primary ACL reconstruction from August 2018 until January 2019. They were evaluated at their 6-month follow-up appointment and underwent functional RTS testing. Patients were divided into 3 groups based on their age: Pre-Adolescent (ages 8-14), Adolescent (ages 15-18), and Adult (ages >18) to reflect their psychological/emotional maturity. Demographic information, time to RTS clearance, and functional testing measurements were collected Analysis included one-way ANOVA and Kruskal-Wallis tests. Results: A total of 65 patients were included in the study (38 males, 27 females; mean age, 17.2 ± 3.3 years). The 3 age groups consisted of Pre-Adolescent (n=12), Adolescent (n=34), and Adult (n=19). The graft types were HS (n=51), BTB (n=8), ITB (n=6). Mean ACL-RSI scores were significantly different among age groups (Pre-Adolescent 80.1±11.1, Adolescent 64.2±23.5, Adult 52.5±19.9; p=0.003) and graft type (HS 63±21.9, BTB 54.3±26.7, ITB 81.9±10.6; p=0.049). Scores were significantly different among the 3 age groups for IKDC (Pre-Adolescent 86.2±12.2, Adolescent 80.3±13.6, Adult 62.1±6.5; p<0.001) and Pedi-FABS (Pre-Adolescent 25.3±5.5, Adolescent 24.8±7.1, Adult 19.6±10.0; p=0.049). The mean PROMIS-PSE t-scores were significantly different among the age groups (Pre-Adolescent 45.7±8.9, Adolescent 52.8±7.6, Adult 52.6±7.4; p=0.023) and graft type (HS 52.5±7.6, BTB 53.2±7.6, ITB 39.8±4.4; p<0.001). We found that ACL-RSI and IKDC had a Spearman correlation of 0.52 (p<0.001) while ACL-RSI and PROMIS-PSE had a Pearson correlation of -0.32 (p=0.009). There were no differences between functional testing across the 3 age groups (p>0.05). Conclusion: This study suggests that psychological profiles and subjective perceptions of knee function following ACL reconstruction may vary in young patients of different ages. Pre-adolescent patients had better scores on all patient reported outcomes compared to adolescent and adult patients. Age-related differences in patient reported outcomes should be taken into account when evaluating young patients. [Figure: see text]

scholarly journals Preoperative PROMIS Scores Predict Postoperative Outcomes After Primary ACL Reconstruction

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711877128 ◽  
Author(s):  
Raymond E. Chen ◽  
M. Owen Papuga ◽  
Ilya Voloshin ◽  
Gregg T. Nicandri ◽  
John P. Goldblatt ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Characteristic Curve ◽  
Postoperative Outcomes ◽  
Measurement Information ◽  
Level Of Evidence ◽  
Meaningful Improvement ◽  
Patient Reported ◽  
Cutoff Scores ◽  
Primary Acl Reconstruction

Background: PROMIS (Patient-Reported Outcomes Measurement Information System) scores in patients undergoing anterior cruciate ligament (ACL) reconstruction have not been fully described in the literature to date. The ability of preoperative patient-reported outcome scores to directly predict postoperative outcomes in patients who undergo primary ACL reconstruction is unknown. Hypothesis: Postoperative PROMIS physical function (PF), pain interference (PI), and depression (D) scores in patients who undergo ACL reconstruction will show improvement when compared with preoperative scores. Additionally, preoperative PROMIS PF, PI, and D scores will predict which patients will not achieve a minimal clinically important difference (MCID) postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 233 patients who underwent primary ACL reconstruction between 2015 and 2016 and had completed PROMIS measures both preoperatively (within 60 days of surgery) and postoperatively (100-240 days after surgery) were included in this study. PROMIS PF, PI, and D scores were compared. Accuracy analyses were performed to determine whether preoperative PROMIS scores from each domain could predict postoperative achievement of MCID in the same domain. Cutoff scores were then calculated. Results: PROMIS PF, PI, and D scores all showed a significant improvement after ACL reconstruction (all P < .001). Preoperative scores from all 3 PROMIS domains showed a strong ability to predict clinically meaningful improvement, as defined by MCID, with areas under the receiver operating characteristic curve from 0.72 to 0.84. Optimal cutoffs for preoperative PROMIS scores showed that patients with a PF score of <42.5, PI score of >56.2, or D score of >44.8 were more likely to achieve MCID. Conclusion: PROMIS PF, PI, and D scores improved significantly in patients who underwent primary ACL reconstruction. Preoperative PROMIS PF, PI, and D scores were highly predictive of outcome in the early postoperative period. The reported cutoff scores showed high probability in predicting which patients would and would not achieve a clinically meaningful improvement.

scholarly journals Bridge-Enhanced ACL Repair: Two Year Results of the First In Human Study

2019 ◽  
Vol 7 (3_suppl2) ◽  
pp. 2325967119S0019
Author(s):  
Martha M. Murray ◽  
Leslie Kalish ◽  
Braden C. Fleming ◽  
Brett Flutie ◽  
Laura Thurber ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Human Study ◽  
Hamstring Tendon ◽  
Suture Repair ◽  
Hamstring Autograft ◽  
Acl Repair ◽  
Time Points ◽  
Patient Reported ◽  
Kt 1000 ◽  
Objective Score

Objectives: The Bridge-Enhanced ACL Repair (BEAR) procedure is an alternate form of anterior cruciate ligament (ACL) surgery that involves suture repair of the ligament combined with a scaffold to bridge the gap between the torn ligament ends. In this paper, we report outcomes of this procedure and a non-randomized concurrent control group receiving ACL reconstruction with quadrupled hamstring tendon autograft. We hypothesized that patients treated with Bridge-Enhanced ACL Repair would have physical exam findings, patient reported outcomes and adverse events at one and two years that were similar to patients treated with ACL reconstruction. Methods: This was an observational cohort study. Twenty patients were enrolled. Ten patients received a Bridge-Enhanced ACL Repair (BEAR®) and 10 received a hamstring autograft ACL reconstruction. Outcomes were assessed at time points up to 2 years post-operatively, including the International Knee Documentation Committee (IKDC) Subjective Score, the IKDC Objective score, KT-1000 testing for AP laxity and functional testing. Results: There were no graft or repair failures in the first two years after surgery. The IKDC Subjective Scores in both groups improved significantly from baseline (p< 0.0001) but were similar in BEAR and ACL reconstruction groups at 12 and 24 months. An IKDC Objective score of A (normal) was found in 44% of the patients in the BEAR group and 29% of the patients in the ACL reconstruction group at two years; no patients in either group had a grade of C (abnormal) or D (severely abnormal). KT-1000 testing demonstrated a side to side difference that was similar in the two groups at 2 years (mean(±SD) 1.9(± 2.1) mm in the BEAR group, 3.1(± 2.7) mm in the ACLR group). Functional hop testing results were similar in the two groups at 1 and 2 years after surgery. Hamstring strength indices measured by dynamometer were significantly higher at all time points in the BEAR group than in the hamstring autograft group (mean percentages relative to contralateral side at two years, 98.6%(±10.5%) vs 56.3%(±19.0%), p=0.0001). Conclusion: In a small first-in-human study, Bridge-Enhanced ACL Repair produced similar outcomes to ACL reconstruction with autograft quadruple bundle hamstring tendon.

scholarly journals Vancomycin presoaking of hamstring grafts removes the risk of infection in primary anterior cruciate ligament reconstruction

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0018
Author(s):  
Francisco Figueroa ◽  
David Figueroa ◽  
Rafael Calvo ◽  
Alex Vaisman ◽  
Mario López ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Septic Arthritis ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Autograft ◽  
Exact Test ◽  
Previous Period ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction ◽  
Hamstring Grafts

Background: Several strategies have been studied to decrease the rate of infection after hamstring autograft anterior cruciate ligament (ACL) reconstruction. Our group started presoaking grafts with Vancomycin in November 2015 to decrease this risk. Purpose: The objective of the study is to compare the success of this protocol against the immediate previous period in which we did not use the protocol. Study design: Retrospective cohort. Level III. Methods: Consecutive periods were studied: April 2013-October 2015 (pre Vancomycin protocol) and November 2015- May 2018 (Vancomycin protocol). All patients that underwent a hamstring autograft primary ACL reconstruction during the periods studied were included. The final outcome was the presence of postoperative septic arthritis in both groups. Diagnosis of septic arthritis was made using the clinical picture plus cytological analysis of a joint aspiration (cell count > 50.000/uL + > 90% neutrophils) Statistical analysis was made using the Fisher’s exact test. Significance was set in p < 0.05. Results: 490 patients were included in the study, 230 in the pre Vancomycin protocol an 260 in the Vancomycin protocol. 4 postoperative septic arthritis were noted in the pre Vancomycin protocol (1.7%) while no septic arthritis was noted in the post Vancomycin protocol patients during the period studied. (p < 0.05) The 4 postoperative infections were presented at an average 21.7 days (range 16-25). Staphylococcus epidermidis was isolated in 2 of the cases, and in the other 2 no organism was isolated. Conclusion: Vancomycin presoaking of hamstring autografts in primary ACL reconstruction eliminated the risk of postoperative septic arthritis during the studied period compared to the immediate previous period, where no Vancomycin presoaking was used.

scholarly journals ACL Graft Signal Characteristics Measured by Quantitative MRI Are Significantly Correlated with Patient Reported Outcomes Two-Years after Hamstring Autograft ACL Reconstruction

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0035
Author(s):  
Drew A. Lansdown ◽  
Weiyuan Xiao ◽  
Alan L. Zhang ◽  
Christina R. Allen ◽  
Brian T. Feeley ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Quantitative Imaging ◽  
Relaxation Times ◽  
Tendon Graft ◽  
Hamstring Autograft ◽  
Acl Graft ◽  
Non Invasive ◽  
Patient Reported ◽  
Proteoglycan Content ◽  
Over Time

Objectives: Following surgical reconstruction of the anterior cruciate ligament (ACL), the tendon graft undergoes a remodeling process of ligamentization. Collagen within the ACL graft becomes organized along the long-axis of the ligament and the proteoglycan content increases. Quantitative imaging sequences, specifically T2 and T1rho, allow for a non-invasive assessment of collagen orientation and proteoglycan content, respectively. The purpose of this study was to investigate the longitudinal progression of T2 and T1rho relaxation times of the graft after ACL reconstruction and the relationship between these quantitative imaging markers and patient-reported outcome measures. We hypothesized that T2 and T1rho would decrease significantly over time, reflecting improved collagen organization and ncreased proteoglycan content, and that T2 and T1rho relaxation times would be inversely correlated with Knee Osteoarthritis Outcome Scores (KOOS). Methods: Thirty-two patients (mean age 29.4±8.2 years, 12 females) were followed prospectively after arthroscopic ACL reconstruction with hamstring autograft. Patients provided informed consent and all procedures were IRB-approved. Exclusion criteria included allograft reconstruction, other ligamentous injury, meniscal tear requiring repair, prior knee surgery, or history of arthritis. Post-operative MR imaging was obtained for 31 patients at 6 months, 30 patients at 12 months, 26 patients at 24 months, and 23 patients at 36 months after surgery. T2 and T1rho relaxation times were simultaneously acquired with a combined 3D sagittal sequence using a 3 T MR system (GE Healthcare) with a 1Tx/8Rx knee coil. The intra-articular ACL graft was identified on a fat-suppressed sagittal high-resolution 3D fast spin echo images and manually segmented. The T2 and T1rho relaxation times for the graft were recorded. Patients completed the KOOS at each imaging time point. Repeated measures analysis of variance (ANOVA) tests with Tukey corrections were used to compare T2 and T1rho relaxation times between time points. The relationship between KOOS and T2 and T1rho values at 2 years post-operative was investigated with Spearman’s rank correlation. Significance was defined as p<0.05. Results: The T2 relaxation times of the ACL graft were significantly higher at 6 months relative to 12 months (p<0.001), 24 months (p<0.001,) and 36 months (p<0.001) after ACL reconstruction, as well as significantly higher at 12 months relative to 36 months (p<0.001) (Figure 1A). The T1rho relaxation times of the ACL graft were significantly higher at 6 months relative to 12 months (p<0.001), 24 months (p<0.001), and 36 months (p<0.001) (Figure 1B). The two-year T2 relaxation times and T1rho relaxation times were significantly correlated with the KOOS Sports, Pain, Symptoms, and Activities of Daily Living sub-scores. Conclusion: We observed significant changes in the tendon graft over time following ACL reconstruction with hamstring autograft, reflecting a higher concentration of proteoglycan and more longitudinally-organized collagen structure over time. Improved collagen organization (lower T2 values) and increased proteoglycan content (lower T1rho values) were correlated with better outcomes based on KOOS scores. Quantitative T2 and T1rho relaxation times of ACL graft may offer a non-invasive method for monitoring graft maturation that correlates with patient-reported knee function after ACL reconstruction. [Figure: see text][Table: see text]

Limitations in predicting outcome following primary ACL reconstruction with single-bundle hamstring autograft — A systematic review

The Knee ◽  
2017 ◽  
Vol 24 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Vincent VG An ◽  
Corey Scholes ◽  
Vikram A Mhaskar ◽  
William J Hadden ◽  
David Parker
Keyword(s):  
Systematic Review ◽  
Acl Reconstruction ◽  
Single Bundle ◽  
Hamstring Autograft ◽  
Predicting Outcome ◽  
Primary Acl Reconstruction

scholarly journals Poor Associations Between Radiographic Tibiofemoral Osteoarthritis and Patient-Reported Outcomes at 16 Years After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712095117
Author(s):  
Fredrik Identeg ◽  
Eric Hamrin Senorski ◽  
Eleonor Svantesson ◽  
Kristian Samuelsson ◽  
Ninni Sernert ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Patient Reported Outcomes ◽  
Cruciate Ligament ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
Ikdc Score ◽  
Anterior Cruciate ◽  
Grade 3

Background: Radiographic tibiofemoral (TF) osteoarthritis (OA) is common in patients after anterior cruciate ligament (ACL) reconstruction at long-term follow-up. The association between radiographic OA and patient-reported outcomes has not been thoroughly investigated. Purpose: To determine the association between radiographic TF OA and patient-reported outcome measure (PROM) scores at 16 years after ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: This study was based on 2 randomized controlled studies comprising 193 patients who underwent unilateral ACL reconstruction. A long-term follow-up was carried out at 16.4 ± 1.7 years after surgery and included a radiographic examination of the knee and recording of PROM scores. Correlation analyses were performed between radiographic OA (Kellgren-Lawrence [K-L], Ahlbäck, and cumulative Fairbank grades) and the PROMs of the International Knee Documentation Committee (IKDC) subjective knee form, Lysholm score, and Tegner activity scale. A linear univariable regression model was used to assess how the IKDC score differed with each grade of radiographic OA. Results: Of 193 patients at baseline, 147 attended the long-term follow-up. At long-term follow-up, 44.2% of the patients had a K-L grade of ≥2 in the injured leg, compared with 6.8% in the uninjured leg. The mean IKDC score at follow-up was 71.2 ± 19.9. Higher grades of radiographic OA were significantly correlated with lower IKDC and Lysholm scores ( r = –0.36 to –0.22). Patients with a K-L grade of 3 to 4 had significantly lower IKDC scores compared with patients without radiographic OA (K-L grade 0-1). Adjusted beta values were –15.7 (95% CI, –27.5 to –4.0; P = .0093; R 2 = 0.09) for K-L grade 3 and –25.2 (95% CI, –41.7 to –8.6; P = .0033; R 2 = 0.09) for K-L grade 4. Conclusion: There was a poor but significant correlation between radiographic TF OA and more knee-related limitations, as measured by the IKDC form and the Lysholm score. Patients with high grades of radiographic TF OA (K-L grade 3-4) had a statistically significant decrease in IKDC scores compared with patients without radiographic TF OA at 16 years after ACL reconstruction. No associations were found between radiographic TF OA and the Tegner activity level.

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