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Patients with ACL graft deficiency showed a higher frequency of knee osteoarthritis compared with patients with intact ACL graft in the medium term

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Abstract

Aim

To evaluate whether patients with anterior cruciate ligament (ACL) graft tear who do not undergo revision reconstruction surgery are more likely to exhibit osteoarthritic features than patients with intact ACL graft using MRI.

Materials and methods

We retrospectively evaluated our hospital medical archive for identifying all consecutive patients with ACL graft failure who underwent MRI between January 2015 and January 2019. An equal number of patients with intact ACL graft was selected for the control group. An observer with 6 years of musculoskeletal radiology experience evaluated the baseline and last available follow-up MRIs of the patients for bone marrow lesions (BMLs), cartilage defects, osteophytes, anterior tibial translation, and effusion-synovitis.

Results

A total of 130 patients, 118 males (90.8%), and 12 females (9.2%), with the mean age of 29.22 ± 9.3 years, were enrolled in the study. Of 130 patients, 65 had a deficient ACL graft, and 65 had an intact ACL graft. The time from the index injury to the last follow-up MRI was 45 months (IQR, 19) for the study cohort. On the follow-up MRIs, patients with ACL graft deficiency showed more prominent degenerative features compared with the patients with intact ACL graft characterized as follows: higher grades of medial meniscal tears (P = 0.06); higher grades of BMLs in the anteromedial (P = 0.014) and posteromedial (P = 0.006) femur, higher grades of cartilage defects in the medial patella (p = 0.0P); higher grades of osteophytes in the anteromedial (P = 0.018) and central medial femur (p = 0.048), central medial tibia (P = 0.048), and medial patella (P = 0.07); and more frequent anterior tibial translation (P = 0.022).

Conclusion

Patients with ACL graft deficiency present with more prominent degenerative features, particularly on the medial side, suggestive of osteoarthritis compared with patients with intact ACL grafts in the medium-term follow-up.

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Data availability

The data supporting our findings can be found in the article. Given the strict regulations of our institutional review board, further data of the patients only available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Halkali, Istanbul, Turkey

    Ozan Asmakutlu & Cagdas Topel

  2. Department of Radiology, Istanbul Acibadem Mehmet Ali Aydinlar University, Maslak Hospital, Istanbul, Turkey

    Deniz Alis

  3. Department of Radiology, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Sisli, Istanbul, Turkey

    Mujdat Bankaoglu

Authors
  1. Ozan Asmakutlu
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  2. Deniz Alis
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  3. Cagdas Topel
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  4. Mujdat Bankaoglu
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Correspondence to Ozan Asmakutlu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants.

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Asmakutlu, O., Alis, D., Topel, C. et al. Patients with ACL graft deficiency showed a higher frequency of knee osteoarthritis compared with patients with intact ACL graft in the medium term. Skeletal Radiol 50, 137–148 (2021). https://doi.org/10.1007/s00256-020-03549-y

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  • DOI: https://doi.org/10.1007/s00256-020-03549-y

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