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High Incidence Of Osteoarthritis Observed In Patients At Short- To Mid-Term Follow-Up After Delayed Multiligament Knee Reconstruction


Camilo P. Helito, MD, PhD, Prof
BRAZIL

High Incidence Of Osteoarthritis Observed In Patients At Short- To Mid-Term Follow-Up After Delayed Multiligament Knee Reconstruction

Camilo P. Helito, MD, PhD, Prof, BRAZIL Marcel F. Sobrado, MD, PHD, BRAZIL Pedro N. Giglio, MD, BRAZIL Marcelo B. Bonadio, MD, BRAZIL Riccardo Gomes Gobbi, MD, PhD, BRAZIL José R. Pécora, Prof., BRAZIL Fabio J. Angelini, MD, BRAZIL

University of São Paulo, São Paulo, São Paulo, BRAZIL

2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Knee

Anatomic Structure

Ligaments Bones Cartilage

Diagnosis / Condition

Osteoarthritis Dislocation Trauma Arthritis Instability

Treatment / Technique

Repair / Reconstruction Arthroscopy Failed

Ligaments

PCL MC Ligament LC Ligament ACL Posterolateral Corner

Diagnosis Method

Physical Examination X-ray MRI

Sports Medicine

Sport Specific Injuries Outcome Studies

Cartilage

Cartilage Injuries

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Summary: There is a high incidence of knee osteoarthritis following ligament reconstruction for chronic multi-ligament knee injuries. Ligament reconstruction failure was the only independent predictor for the development of osteoarthritis in our study

Introduction

The aim of this study was to evaluate the incidence of knee osteoarthritis, failure rate of reconstruction and clinical outcomes of patients with chronic multi-ligament knee injuries subjected to surgical treatment.

Methods

Sixty-two patients with chronic knee dislocation subjected to multiligament reconstruction between April 2008 and July 2016 were evaluated, with a minimum follow-up of 24 months. Anteroposterior and lateral radiographs were performed in the pre- and last postoperative evaluation; the progression of degenerative changes according to the Kellgren-Lawrence classification (KL) was assessed. The Schenck classification, Knee Injury and Osteoarthritis Outcome Score (KOOS), time between injury and surgery, type of post-operative rehabilitation protocol (brace versus external fixator) and physical examination for ligament instability were also evaluated. Univariate and multivariate analysis were performed, p<0.05 was considered significant.

Results

Fifty-two (83.9%) patients were men and 16.1% (n=10) were women, with a mean age of 38.8 ± 1.3 years. The time from injury to surgery was 31.1 ± 6.1 months, and the follow-up time was 6.1 ± 0.5 years. The mean final KOOS was 79.3 ± 10.4 and the overall reconstruction failure occurred in 25.8%. Of all patients, 64.5% (n=40) presented a KL classification of =2 and were defined as having radiographic osteoarthritis (OA). As 11.7% (n=7) also presented arthritis in the contralateral knee, in 53.2% (n=33) the progression was most likely due to the initial injury. The failure of ligament reconstruction or residual instability was present in 15 (35,7%) of patients with OA and only one patient (4,5%) without OA. In the multivariate analysis, only reconstruction failure was an independent predictor of OA (O.R.=13.2 [p=0.028]).

Conclusion

There is a high incidence of knee OA following ligament reconstruction for chronic multi-ligament knee injuries. Ligament reconstruction failure was the only independent predictor for the development of OA in our study.

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