Early patellofemoral osteoarthritis features one year after anterior cruciate ligament reconstruction: symptoms and quality of life at three years

Culvenor, Adam G., Collins, Natalie J., Guermazi, Ali, Cook, Jill L., Vicenzino, Bill, Whitehead, Timothy S., Morris, Hayden G. and Crossley, Kay M. (2016) Early patellofemoral osteoarthritis features one year after anterior cruciate ligament reconstruction: symptoms and quality of life at three years. Arthritis Care and Research, 68 6: 784-792. doi:10.1002/acr.22761


Author Culvenor, Adam G.
Collins, Natalie J.
Guermazi, Ali
Cook, Jill L.
Vicenzino, Bill
Whitehead, Timothy S.
Morris, Hayden G.
Crossley, Kay M.
Title Early patellofemoral osteoarthritis features one year after anterior cruciate ligament reconstruction: symptoms and quality of life at three years
Journal name Arthritis Care and Research   Check publisher's open access policy
ISSN 2151-4658
2151-464X
Publication date 2016-06-01
Year available 2016
Sub-type Article (original research)
DOI 10.1002/acr.22761
Open Access Status Not yet assessed
Volume 68
Issue 6
Start page 784
End page 792
Total pages 9
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Collection year 2017
Language eng
Formatted abstract
Objective: To determine whether the presence of magnetic resonance imaging (MRI) osteoarthritis (OA) features in the patellofemoral or tibiofemoral joint (i.e., bone marrow lesions, cartilage lesions, and osteophytes) and/or functional impairments, 1 year following anterior cruciate ligament reconstruction (ACLR), can predict Knee Injury and Osteoarthritis Outcome Score (KOOS) at 3 years.

Methods: A total of 93 participants (56 [60%] men, mean ± SD age 29 ± 9 years) who had undergone MRI examination and functional testing at 1-year post-ACLR, completed the KOOS at 3 years postsurgery. Multivariate regression models evaluated the prognostic capacity of compartment-specific osteochondral OA features, scored using the MRI Osteoarthritis Knee Score, and functional performance (hop for distance, 1-leg rise), to predict outcome on 4 KOOS subscales (pain, symptoms, sport/recreation, and quality of life [QOL]).

Results: Presence of patellofemoral cartilage lesions 1-year post-ACLR predicted worse score on all KOOS subscales at 3 years (P ≤ 0.01). Regression coefficients (B) were -5.1 (95% confidence interval [95% CI] -9.1, -1.2) for symptoms, -4.0 (95% CI -6.7, -1.4) for pain, -6.7 (95% CI -11.0, -2.4) for sport/recreation, and -8.6 (95% CI -15.1, -2.1) for QOL. No significant associations were found between tibiofemoral MRI features and knee symptoms. Poorer performance on the 1-leg-rise test predicted worse KOOS-QOL (B -6.5 [95% CI -12.4, -0.5], P = 0.03).

Conclusion: The presence of a patellofemoral articular cartilage lesion and lower 1-leg-rise performance at 1 year postsurgery are prognostic for poorer 3-year outcome following ACLR. Particular attention to patellofemoral compartment lesions and functional capacity is warranted during postoperative rehabilitation programs, as these features represent potential targets for therapy aimed at minimizing symptomatic disease progression in these young adults.
Keyword Anterior cruciate ligament reconstruction (ACLR)
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Magnetic resonance imaging (MRI)
Patellofemoral articular cartilage lesion
Young adults
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
 
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