HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Appendix A All Versions of this Article: 36/4/671    most recent 0363546508315468v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hanypsiak, B. T. Articles by Parker, R. D. Search for Related Content PubMed PubMed Citation Articles by Hanypsiak, B. T. Articles by Parker, R. D. Related Collections Chondral/cartilage Reconstruction Knee

Twelve-Year Follow-up on Anterior Cruciate Ligament Reconstruction

Long-term Outcomes of Prospectively Studied Osseous and Articular Injuries

Bryan T. Hanypsiak, MD^*, Kurt P. Spindler, MD, Christopher R. Rothrock, MD, Gary J. Calabrese, DO, Brad Richmond, MD, Todd M. Herrenbruck, MD^|| and Richard D. Parker, MD^,¶

From the ^* Orthopaedic Associates of Long Island, E. Setauket, New York, Vanderbilt University Medical Center, Nashville, Tennessee, St. Louis Orthopedic Institute Inc, St. Louis, Missouri, the Cleveland Clinic Foundation, Cleveland, Ohio, and the ^|| Orthopedic Sports Health Clinic of Salina, Salina, Kansas

^¶ Address correspondence to Richard D. Parker, MD, The Cleveland Clinic Foundation, 9500 Euclid Avenue - Desk A 41, Cleveland, OH 44106 (e-mail: parkerr{at}ccf.org).

Background: Although successful at restoring near normal laxity to the knee in the short term, anterior cruciate ligament reconstructions have not been shown to prevent the development of posttraumatic arthritis.

Hypothesis: Bone bruises and articular cartilage injuries sustained at the time of initial injury (1991) would not resolve. Our secondary hypothesis was that the presence of a bone bruise or articular cartilage injury originally identified on magnetic resonance imaging would not be associated with long-term outcomes after anterior cruciate ligament reconstruction evaluated by the International Knee Documentation Committee questionnaire.

Study Design: Cohort study (prognosis); Level of evidence, 1.

Methods: We attempted to contact all patients from an original cohort (N = 54) for follow-up evaluation, which included repeat radiographs, magnetic resonance images, physical examination, and International Knee Documentation Committee questionnaire more than a decade postoperatively.

Results: Forty-four patients (82% of the original cohort) returned for on-site follow-up. No patient with a bone bruise identified on original magnetic resonance imaging had one identified at 12-year follow-up. The mean ( ± SD) International Knee Documentation Committee score at follow-up with no bone bruise originally present was 70.6 ( ± 12.7) versus 70.0 ( ± 8.1) when a bone bruise was observed (P > .05). No consistent association was observed between the presence of an initial articular cartilage lesion with a lesion on follow-up magnetic resonance images. The mean ( ± SD) International Knee Documentation Committee score at follow-up with no articular cartilage injury was 69.0 ( ± 11.9) versus 72.8 ( ± 12.0) with articular cartilage lesion (P > .05).

Conclusion: All bone bruises identified in our study with magnetic resonance imaging at the time of initial injury had resolved at 12-year follow-up. The presence of a bone bruise at the time of initial injury did not significantly alter the patient-oriented outcome by International Knee Documentation Committee after anterior cruciate ligament reconstruction. Additionally, articular cartilage abnormality on magnetic resonance imaging did not influence the International Knee Documentation Committee score.

Key Words: ACL • bone bruise • MRI • long-term • prospective