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Acl Reconstruction Patients Have Increased Risk Of Knee Arthroplasty: Data From The Norwegian Knee Ligament Register And The Norwegian Arthroplasty Register From 2004-2019

2021 Congress Paper Abstracts

Acl Reconstruction Patients Have Increased Risk Of Knee Arthroplasty: Data From The Norwegian Knee Ligament Register And The Norwegian Arthroplasty Register From 2004-2019

Havard Visnes, MD, PT, PhD, NORWAY Tone Gifstad, MD, PhD, NORWAY Andreas Persson, MD, PhD, NORWAY Stein Håkon Låstad Lygre, PhD, NORWAY Lars Engebretsen, MD, PhD, NORWAY Jon Olav Drogset, Prof., NORWAY Ove Furnes, NORWAY

The Norwegian Knee Ligament Register, Bergen, NORWAY


2021 Congress   Abstract Presentation   1 minutes   Not yet rated

 

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Summary: Ten years after an ACL reconstruction, the overall cumulative risk of knee arthroplasty (KA) was 0.5%. Revised ACL reconstruction, cartilage injury at time of ACL reconstruction and KOOS (two years post-operatively, Sport/Rec) <44 were major risk factors for subsequent KA


Background

Anterior cruciate ligament (ACL) injury is considered a risk factor for osteoarthritis.

Aim

The primary aim of the study was to investigate the cumulative risk and risk factors associated with a subsequent knee arthroplasty (KA) after an ACL reconstruction. The secondary aim was to compare the relative risk for KA after ACL reconstruction compared with the general population.

Methods

Cumulative risk and possible risk factors for KA after ACL reconstruction were analyzed by combining data from two national registries, the Norwegian Knee Ligament Register and the Norwegian Arthroplasty Register in a Cox regression model. The relative risk of KA for ACL patients compared with the general population was calculated in stratified age groups.

Results

One hundred and one knees underwent KA out of the eligible study population of 25,931 knees. We found a 0.5% (CI: 0.4-0.6) cumulative risk of KA 10 years after ACL reconstruction. The cumulative risk of knee replacement was significantly higher in patients who were older at the time of their index ACL reconstruction. Revision of the ACL (HR: 4.8, CI: 2.6, 8.9), deep cartilage injury, ICRS (International Cartilage Repair Society) 3-4 (HR: 3.9, CI: 2.4, 6.3) and two-year post-operative KOOS Sport/Rec sub-score<44 (HR: 3.6, CI: 1.7, 7.7) were important risk factors for KA surgery. We found a higher risk of KA at the age of 30-39 years after a previous ACL reconstruction compared to the general population (RR: 3.4 (CI: 1.6-7.1))

Discussion

Some comparable studies have found a slightly higher risk of KA after 10 years than our study, but indications for KA may vary between countries.

Conclusion

Ten years after an ACL reconstruction, the overall cumulative risk of KA was 0.5%. Revised ACL reconstruction, cartilage injury at time of ACL reconstruction and KOOS (two years post-operatively, Sport/Rec) <44 were major risk factors for subsequent KA. Patients with previous ACL surgery at age 30-39 had a 3.4 times higher risk of KA than the general population.

Level of Evidence: level II prospective cohort study.


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