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The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis.

Lohmander, Stefan LU ; Englund, Martin LU ; Dahl, Ludvig LU and Roos, Ewa LU (2007) In American Journal of Sports Medicine 35(10). p.1756-1769
Abstract
The objectives of this study are to review the long-term consequences of injuries to the anterior cruciate ligament and menisci, the pathogenic mechanisms, and the causes. of the considerable variability in outcome. Injuries of the anterior cruciate ligament and menisci are common in both athletes and the general population. At 10 to 20 years after the diagnosis, on average, 50% of those with a diagnosed anterior cruciate ligament or meniscus tear have ostecarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall ostecarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the... (More)
The objectives of this study are to review the long-term consequences of injuries to the anterior cruciate ligament and menisci, the pathogenic mechanisms, and the causes. of the considerable variability in outcome. Injuries of the anterior cruciate ligament and menisci are common in both athletes and the general population. At 10 to 20 years after the diagnosis, on average, 50% of those with a diagnosed anterior cruciate ligament or meniscus tear have ostecarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall ostecarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the anterior cruciate ligament or meniscus against ostecarthritis development. A consistent finding in a review of the literature is the often poor reporting of critical study variables, precluding data pooling or a meta-analysis. Osteoarthritis development in the injured joints is caused by intra-articular pathogenic processes initiated at the time of injury, combined with long-term changes in dynamic joint loading. Variation in outcome is reinforced by additional variables associated with the individual such as age, sex, genetics, obesity, muscle strength, activity, and reinjury. A better understanding of these variables may improve future prevention and treatment strategies. In evaluating medical treatment, we now expect large randomized clinical trials complemented by postmarketing monitoring. We should strive toward a comparable level of quality of evidence in surgical treatment of knee injuries. In instances in which a randomized clinical trial is not feasible, natural history and other observational cohort studies need to be as carefully designed and reported as the classic randomized clinical trial, to yield useful information. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
osteoarthritis (OA), rupture, meniscus, anterior cruciate ligament (ACL), outcome
in
American Journal of Sports Medicine
volume
35
issue
10
pages
1756 - 1769
publisher
American Orthopaedic Society for Sports Medicine
external identifiers
  • wos:000250049800021
  • scopus:34748813185
ISSN
1552-3365
DOI
10.1177/0363546507307396
language
English
LU publication?
yes
id
bdd37a6e-b959-4c32-9ede-b78381b14ea3 (old id 608110)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17761605&dopt=Abstract
date added to LUP
2007-12-17 10:28:03
date last changed
2017-11-19 04:16:00
@article{bdd37a6e-b959-4c32-9ede-b78381b14ea3,
  abstract     = {The objectives of this study are to review the long-term consequences of injuries to the anterior cruciate ligament and menisci, the pathogenic mechanisms, and the causes. of the considerable variability in outcome. Injuries of the anterior cruciate ligament and menisci are common in both athletes and the general population. At 10 to 20 years after the diagnosis, on average, 50% of those with a diagnosed anterior cruciate ligament or meniscus tear have ostecarthritis with associated pain and functional impairment: the young patient with an old knee. These individuals make up a substantial proportion of the overall ostecarthritis population. There is a lack of evidence to support a protective role of repair or reconstructive surgery of the anterior cruciate ligament or meniscus against ostecarthritis development. A consistent finding in a review of the literature is the often poor reporting of critical study variables, precluding data pooling or a meta-analysis. Osteoarthritis development in the injured joints is caused by intra-articular pathogenic processes initiated at the time of injury, combined with long-term changes in dynamic joint loading. Variation in outcome is reinforced by additional variables associated with the individual such as age, sex, genetics, obesity, muscle strength, activity, and reinjury. A better understanding of these variables may improve future prevention and treatment strategies. In evaluating medical treatment, we now expect large randomized clinical trials complemented by postmarketing monitoring. We should strive toward a comparable level of quality of evidence in surgical treatment of knee injuries. In instances in which a randomized clinical trial is not feasible, natural history and other observational cohort studies need to be as carefully designed and reported as the classic randomized clinical trial, to yield useful information.},
  author       = {Lohmander, Stefan and Englund, Martin and Dahl, Ludvig and Roos, Ewa},
  issn         = {1552-3365},
  keyword      = {osteoarthritis (OA),rupture,meniscus,anterior cruciate ligament (ACL),outcome},
  language     = {eng},
  number       = {10},
  pages        = {1756--1769},
  publisher    = {American Orthopaedic Society for Sports Medicine},
  series       = {American Journal of Sports Medicine},
  title        = {The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis.},
  url          = {http://dx.doi.org/10.1177/0363546507307396},
  volume       = {35},
  year         = {2007},
}