2023 ISAKOS Biennial Congress ePoster
Varus Alignment Was a Risk Factor For Osteoarthritis of the Knee After the Anterior Cruciate Ligament Injury: A Systematic Review and Meta-Analysis
Junya Itou, MD, PhD, Tokyo JAPAN
Masafumi Itoh, MD, PhD, Tokyo JAPAN
Umit Kuwa, MD, PhD, Tokyo JAPAN
Ken Okazaki, MD, PhD, Tokyo JAPAN
Kiyotaka Iwasaki, Prof, Shinjuku-Ku, Tokyo JAPAN
Tokyo Women's Medical University, Shinjuku, Tokyo, JAPAN
FDA Status Not Applicable
Summary
Varus alignment was a risk factor for osteoarthritis of the knee after the anterior cruciate ligament
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Abstract
Introduction
Although several risk factors such as meniscal injury or cartilage damage for osteoarthritis (OA) of the knee after anterior cruciate ligament (ACL) injury without a history of ACL reconstruction were detected, it was not well known whether malignment was associated with OA after ACL injury. Therefore, the purpose of this study was to investigate the association between malalignment and OA after ACL injury without ACL reconstruction.
Methods
A meta-analysis was performed after a systematic literature search (July 2022) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The databases MEDLINE, Web of Science, and Cochrane were searched in July 2022. Search terms used were “osteoarthritis,” anterior cruciate ligament,” injury,” tear,” and “rupture.” Inclusion criteria were reports of OA after ACL injury without ACL reconstruction. Exclusion criteria were non-clinical reports, non-English reports, and review articles. For the diagnosis of OA, only reports of clinical studies with radiographic grading criteria results evaluated were considered, whereas those with magnetic resonance imaging or clinical symptoms were excluded. Risk of bias and quality of evidence were assessed following the Cochrane guidelines. Using RevMan software 5.3, the differences between varus alignment and neutral or valgus in terms of prevalence of OA were assessed through the Mantel-Hanszel test and expressed as risk ratios for dichotomous variables (RR = risk ratio varus / neutral or valgus).
Results
SECTION: A total of 3279 articles were identified, and finally 2 articles and 107 knees were included in the quantitative analysis (Fig.1). Varus malalignment did affect the prevalence of OA after ACL injury without ACL reconstruction (Relative risk = 5.46 (P =.004), with the heterogeneity of 0% (P = .82)) (Fig.2).
Conclusion
Varus alignment was a risk factor for osteoarthritis of the knee after the anterior cruciate ligament.
SIGNIFICANCE/CLINICAL RELEVANCE: Surgeons should consider the indication for valgus osteotomy for the anterior cruciate ligament rupture with varus alignment.