ArticleThe American journal of sports medicine2024
Outcomes >30 Years After Initial Nonoperative Treatment of Anterior Cruciate Ligament Injuries.
Article in The American journal of sports medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 11 citations in OpenAlex.
- Assessment of the GNRB Arthrometer: High Inter-Rater Reliability Alone Does Not Support Replacement of the KT1000 in Anterior Cruciate Ligament Reconstruction Patients.Arthroscopy, sports medicine, and rehabilitation · 2026Article
- Reconstruction After an Anterior Cruciate Ligament Injury Does Not Reduce the Osteoarthritis Risk But Lowers the Total Knee Arthroplasty Rate: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2026Review
- High posterior tibial slope is associated with higher failure rates in nonoperative management of primary anterior cruciate ligament injury.Journal of experimental orthopaedics · 2025Article
- Prospective Preference Assessment of a Pharmacological Clinical Trial to Alter the Progression of Posttraumatic Osteoarthritis After ACL Reconstruction.Orthopaedic journal of sports medicine · 2025Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is unclear how anterior cruciate ligament (ACL) reconstruction (ACLR) affects the development of osteoarthritis (OA). This uncertainty is partly caused by the lack of long-term studies on ACL injuries treated primarily without reconstruction and the underreporting of symptomatic OA. PURPOSE: To determine (1) the knee function, symptoms, and activity level, as well as the presence of radiographic and symptomatic OA; (2) how these clinical outcomes have changed over time; and (3) the frequency of subsequent knee surgeries after the index ACL injury in a cohort of patients with ACL injuries treated primarily without reconstruction. STUDY
designCase series; Level of evidence, 4.
methodsA total of 100 patients underwent initial nonoperative treatment >30 years ago (mean, 33.2 ± 1.4 years). Of these, 81 patients (mean age, 59 ± 8 years) completed the Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm Knee Scoring Scale, and Tegner Activity Scale. Seventy-three patients underwent radiography to evaluate tibiofemoral and patellofemoral OA in the ACL-injured knee. Patients only underwent late ACLR if they experienced insufficient knee stability.
resultsAt 33 years after the ACL injury, the KOOS Activities of Daily Living subscore was better than population-based reference values, but scores were similar for the remaining KOOS subscales. Furthermore, 65% of patients had a good or excellent Lysholm score (≥84 points). The Tegner score decreased 4 points from before the injury to 33-year follow-up (
conclusionDespite a high prevalence of radiographic OA, patients achieved acceptable subjective knee function and had a relatively low prevalence of symptomatic OA at >30 years after an ACL injury when an initial nonoperative treatment strategy was employed.
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