ΕλληνικάTen year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes
Ten year follow-up study comparing conservative
versus operative treatment of anterior cruciate
ligament ruptures. A matched-pair analysis of
high level athletes
D E Meuffels, M M Favejee, M M Vissers, M P Heijboer, M Reijman and J A N
Verhaar
Br. J. Sports Med. 2009;43;347-351
ABSTRACT
Objective: To compare long term outcome of highly
active patients with anterior cruciate ligament ruptures
treated operatively versus non-operatively.
Design: We reviewed high level athletes with an anterior
cruciate ligament rupture on either MRI or arthroscopic
evaluation more than 10 years previously, who were
treated conservatively. They were pair-matched with
patients who had had an anterior cruciate ligament
reconstruction with bone-patella-tendon-bone, with
respect to age, gender and Tegner activity score before
injury.
Participants: In total 50 patients were pair-matched.
Results: We found no statistical difference between the
patients treated conservatively or operatively with respect
to osteoarthritis or meniscal lesions of the knee, as well
as activity level, objective and subjective functional
outcome. The patients who were treated operatively had
a significantly better stability of the knee at examination.
Conclusion: We conclude that the instability repair using
a bone-patella-tendon-bone anterior cruciate ligament
reconstruction is a good knee stabilising operation. Both
treatment options however show similar patient outcome
at 10 year follow up.
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Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes
Objective: To compare long term outcome of highly active patients with anterior cruciate ligament ruptures treated operatively versus non-operatively.
Design: We reviewed high level athletes with an anterior cruciate ligament rupture on either MRI or arthroscopic evaluation more than 10 years previously, who were treated conservatively. They were pair-matched with patients who had had an anterior cruciate ligament reconstruction with bone-patella-tendon-bone, with respect to age, gender and Tegner activity score before injury.Participants: In total 50 patients were pair-matched.
Results: We found no statistical difference between the patients treated conservatively or operatively with respect to osteoarthritis or meniscal lesions of the knee, as well as activity level, objective and subjective functional outcome. The patients who were treated operatively had a significantly better stability of the knee at examination.
Conclusion: We conclude that the instability repair using
a bone-patella-tendon-bone anterior cruciate ligament reconstruction is a good knee stabilising operation. Both treatment options however show similar patient outcome at 10 year follow up.
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The ability to recognize the ACL deficient knee is lacking, even among orthopaedic surgeons. The history of an acute ACL tear is remarkably constant, because the injury is often non contact, and patients usually report a twist on the flexed knee, turning to the same side as the injured knee, although hyperextension or direct injury is the cause in some sports. Patients often remember a loud pop, but, because there are no nociceptors in the ACL, pain is not an immediate feature in the isolated lesion. Players may attempt to continue to play, but they usually stop because the knee feels insecure. Pain ensues in association with a hemarthrosis: 70% of acute hemarthroses of the knee are associated with a tear of the ACL. The diagnosis must be confirmed before treatment is offered.
