Clinical and Radiographic Outcomes of Anterior Cruciate Liga
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The short-term outcomes of anterior cruciate ligament (ACL) reconstruction with bone–patellar tendon–bone or hamstring tendon (HT) graft are excellent with good clinical stability and patient-reported outcomes.

A Study as performed to assess clinical and radiographic outcomes of HT graft ACL reconstruction with femoral cortical button fixation at a minimum 20-year follow-up in which all patients undergoing isolated transtibial primary ACL reconstruction with HT graft and femoral cortical button fixation were assessed clinically and radiographically. Follow-up was obtained in 48 of 94 patients (51%).

Graft rupture, reoperation, and contralateral injury rates were assessed; clinical stability was measured using the KT-1000 arthrometer; patient-reported outcomes were assessed, Lysholm, Forgotten Joint Score, Tegner activity, Knee injury and Osteoarthritis Outcome Score [KOOS], Anterior Cruciate Ligament Quality of Life [ACL-QOL], EuroQol 5-Dimension 5-Level [EQ-5D-5L]); and radiographic osteoarthritis (defined as Kellgren-Lawrence grade more than 2) was assessed for the ipsilateral and the contralateral knee.

Results:
--Graft rupture occurred in 4 patients (8%), contralateral injury in 4 patients (8%), and reoperation in 15 patients (31%), which consisted mainly of meniscal tears or hardware removal.

--In patients with an intact graft, excellent patient-reported outcome measures (PROMs) were noted, with a median Lysholm of 90, subjective IKDC of 86, and KOOS–Sports of 86.

--There was low awareness of the operated knee (Forgotten Joint Score, 81 and good quality of life (ACL-QOL, 85; EQ-5D-5L, 0.87).

--Median side-to-side difference, as measured with the KT-1000 arthrometer, was 1 mm.

--Radiographic osteoarthritis was evident in 49% of ipsilateral and 10% of contralateral knees and was associated with meniscectomy at index surgery and decreased PROMs at follow-up.

To summarize, the long-term results of transtibial HT graft ACL reconstruction with femoral cortical button fixation are generally positive, with a low failure rate, low awareness of the operated knee, and strong clinical stability. At a 20-year follow-up, radiographic osteoarthritis was seen in around half of the patients, and it was linked to meniscectomy at the index surgery and lower PROMs at the follow-up.

Source: https://journals.sagepub.com/doi/abs/10.1177/0363546520951796?journalCode=ajsb
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