The Clinical Radiographic Incidence of Posttraumatic Osteoarthritis 10 Years After Anterior Cruciate Ligament Reconstruction: Data From the MOON Nested Cohort.
ACL reconstruction
joint space narrowing
posttraumatic osteoarthritis
radiographic osteoarthritis
weightbearing radiographs
Journal
The American journal of sports medicine
ISSN: 1552-3365
Titre abrégé: Am J Sports Med
Pays: United States
ID NLM: 7609541
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
entrez:
1
4
2021
pubmed:
2
4
2021
medline:
28
4
2021
Statut:
ppublish
Résumé
The incidence of posttraumatic osteoarthritis (PTOA) based on clinical radiographic grading criteria at 10 years after anterior cruciate ligament (ACL) reconstruction (ACLR) has not been well-defined in a prospective cohort of young athletic patients. Among young athletic patients, there is a high incidence of clinical radiographic PTOA at 10 years after ACLR. Additionally, there is a significant difference in clinical radiographic osteoarthritis (OA) changes (joint space narrowing and osteophyte formation) between ACL-reconstructed and contralateral knees at 10 years. Case series; Level of evidence, 4. The first 146 patients in an ongoing nested cohort study of the Multicenter Orthopaedic Outcomes Network (MOON) prospective cohort presented for a minimum 10-year follow-up. Included patients had a sports-related ACL injury, were aged <33 years at the time of ACLR, had no history of ipsilateral or contralateral knee surgery, and did not undergo revision ACLR before follow-up. Bilateral knee metatarsophalangeal view radiographs were obtained and graded according to International Knee Documentation Committee (IKDC), Osteoarthritis Research Society International (OARSI), and modified Kellgren-Lawrence (KL) criteria by 2 blinded reviewers. The incidence and severity of ipsilateral and contralateral radiographic OA were determined among patients without a contralateral ACL injury before 10-year follow-up (N = 133). Interrater reliability was substantial for the IKDC (Gwet Agreement Coefficient [AC] 1 = 0.71), moderate for the KL (0.48), and almost perfect for the OARSI (0.84) grading systems. Among patients with a contralateral radiographically normal knee, the 10-year incidence of clinical radiographic PTOA after ACLR was 37% as defined by osteophytes and 23% as defined by joint space narrowing. The maximum side-to-side difference in the OARSI osteophyte grade in the medial or lateral compartment was 0 in 65% of patients, 1 in 20%, and ≥2 in 15%. The maximum side-to-side difference in the OARSI joint space narrowing grade was 0 in 77% of patients, 1 in 19%, and ≥2 in 4%. In young active patients, the 10-year incidence of clinical radiographic PTOA after ACLR was 37% as defined by osteophytes and 23% as defined by joint space narrowing. The mean difference in the degree of osteophyte formation (≤1 grade in 85%) and joint space narrowing (≤1 grade in 96%) between the ACL-reconstructed and contralateral knees was small. NCT02717559 (ClinicalTrials.gov identifier).
Sections du résumé
BACKGROUND
The incidence of posttraumatic osteoarthritis (PTOA) based on clinical radiographic grading criteria at 10 years after anterior cruciate ligament (ACL) reconstruction (ACLR) has not been well-defined in a prospective cohort of young athletic patients.
HYPOTHESIS
Among young athletic patients, there is a high incidence of clinical radiographic PTOA at 10 years after ACLR. Additionally, there is a significant difference in clinical radiographic osteoarthritis (OA) changes (joint space narrowing and osteophyte formation) between ACL-reconstructed and contralateral knees at 10 years.
STUDY DESIGN
Case series; Level of evidence, 4.
METHODS
The first 146 patients in an ongoing nested cohort study of the Multicenter Orthopaedic Outcomes Network (MOON) prospective cohort presented for a minimum 10-year follow-up. Included patients had a sports-related ACL injury, were aged <33 years at the time of ACLR, had no history of ipsilateral or contralateral knee surgery, and did not undergo revision ACLR before follow-up. Bilateral knee metatarsophalangeal view radiographs were obtained and graded according to International Knee Documentation Committee (IKDC), Osteoarthritis Research Society International (OARSI), and modified Kellgren-Lawrence (KL) criteria by 2 blinded reviewers. The incidence and severity of ipsilateral and contralateral radiographic OA were determined among patients without a contralateral ACL injury before 10-year follow-up (N = 133).
RESULTS
Interrater reliability was substantial for the IKDC (Gwet Agreement Coefficient [AC] 1 = 0.71), moderate for the KL (0.48), and almost perfect for the OARSI (0.84) grading systems. Among patients with a contralateral radiographically normal knee, the 10-year incidence of clinical radiographic PTOA after ACLR was 37% as defined by osteophytes and 23% as defined by joint space narrowing. The maximum side-to-side difference in the OARSI osteophyte grade in the medial or lateral compartment was 0 in 65% of patients, 1 in 20%, and ≥2 in 15%. The maximum side-to-side difference in the OARSI joint space narrowing grade was 0 in 77% of patients, 1 in 19%, and ≥2 in 4%.
CONCLUSION
In young active patients, the 10-year incidence of clinical radiographic PTOA after ACLR was 37% as defined by osteophytes and 23% as defined by joint space narrowing. The mean difference in the degree of osteophyte formation (≤1 grade in 85%) and joint space narrowing (≤1 grade in 96%) between the ACL-reconstructed and contralateral knees was small.
REGISTRATION
NCT02717559 (ClinicalTrials.gov identifier).
Identifiants
pubmed: 33793363
doi: 10.1177/0363546521995182
pmc: PMC8375261
mid: NIHMS1727111
doi:
Banques de données
ClinicalTrials.gov
['NCT02717559']
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1251-1261Subventions
Organisme : NIAMS NIH HHS
ID : R01 AR053684
Pays : United States
Références
Am J Sports Med. 2016 May;44(5):1215-24
pubmed: 26912282
Am J Sports Med. 2005 Nov;33(11):1654-7
pubmed: 16093545
Br J Math Stat Psychol. 2008 May;61(Pt 1):29-48
pubmed: 18482474
Am J Sports Med. 2014 May;42(5):1049-57
pubmed: 24644301
Br J Sports Med. 2015 Aug;49(15):975-83
pubmed: 25824447
Knee Surg Sports Traumatol Arthrosc. 2015 Dec;23(12):3532-9
pubmed: 25079135
Am J Sports Med. 2012 Feb;40(2):404-13
pubmed: 22116668
Ann Rheum Dis. 1957 Dec;16(4):494-502
pubmed: 13498604
Eur Radiol. 2004 Sep;14(9):1568-73
pubmed: 15150666
Osteoarthritis Cartilage. 2007;15 Suppl A:A1-56
pubmed: 17320422
Arthritis Rheum. 2007 May;56(5):1512-20
pubmed: 17469126
Biometrics. 1977 Mar;33(1):159-74
pubmed: 843571
J Rheumatol. 2004 Aug;31(8):1588-97
pubmed: 15290740
Sports Health. 2015 May;7(3):239-43
pubmed: 26131301
Arthritis Rheumatol. 2015 May;67(8):2085-96
pubmed: 25940308
Ann Rheum Dis. 2000 Aug;59(8):641-6
pubmed: 10913063
Curr Opin Rheumatol. 2009 Mar;21(2):110-7
pubmed: 19339920
Osteoarthritis Cartilage. 2015 Apr;23(4):581-8
pubmed: 25559582
J Rheumatol. 1999 Dec;26(12):2664-74
pubmed: 10606380
BMC Med Res Methodol. 2013 Apr 29;13:61
pubmed: 23627889
Am J Sports Med. 2018 Mar;46(4):876-882
pubmed: 29394877
Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):613-20
pubmed: 22278656
Br J Sports Med. 2019 Sep;53(18):1162-1167
pubmed: 30936063
J Bone Joint Surg Am. 2014 Jul 16;96(14):1145-1151
pubmed: 25031368
Am J Sports Med. 2011 Dec;39(12):2595-603
pubmed: 22021585
Osteoarthritis Cartilage. 1997 Jul;5(4):241-50
pubmed: 9404469
Knee Surg Sports Traumatol Arthrosc. 1993;1(3-4):226-34
pubmed: 8536037
Ann Rheum Dis. 2008 Jul;67(7):1034-6
pubmed: 18198197
Am J Sports Med. 2009 Jul;37(7):1434-43
pubmed: 19567666
Osteoarthritis Cartilage. 2015 Dec;23(12):2191-2198
pubmed: 26162806
Am J Sports Med. 2013 Jun;41(6):1265-73
pubmed: 23618702
J Bone Joint Surg Br. 1961 Nov;43-B:752-7
pubmed: 14038135
Med Phys. 2000 Mar;27(3):580-91
pubmed: 10757609
Am J Sports Med. 2001 Mar-Apr;29(2):213-8
pubmed: 11292048
Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):1967-76
pubmed: 23100047