Early anterior cruciate ligament reconstruction does not affect 5 year change in knee cartilage thickness : secondary analysis of a randomized clinical trial
Wirth, W. ; Eckstein, F. ; Culvenor, A. G. ; Hudelmaier, M. I. ; Stefan Lohmander, L. LU
and Frobell, R. B.
LU
(2021)
In Osteoarthritis and Cartilage
29(4).
p.518-526
- Abstract
Objective: To compare 5-year change in femorotibial cartilage thickness in 121 young, active adults with an acute anterior cruciate ligament (ACL) tear randomized to a strategy of structured rehabilitation plus early ACL reconstruction (ACLR) or structured rehabilitation plus optional delayed ACLR. Design: 62 patients were randomized to early ACLR, 59 to optional delayed ACLR. Magnetic resonance imaging (MRI) was acquired within 4 weeks of injury, at two- and 5-years follow-up. Main outcome was 5-year change in overall femorotibial cartilage thickness. Secondary outcomes included the location-independent cartilage ChangeScore, summarizing thinning and thickening in 16 femorotibial subregions. An exploratory as-treated comparison was... (More)
Objective: To compare 5-year change in femorotibial cartilage thickness in 121 young, active adults with an acute anterior cruciate ligament (ACL) tear randomized to a strategy of structured rehabilitation plus early ACL reconstruction (ACLR) or structured rehabilitation plus optional delayed ACLR. Design: 62 patients were randomized to early ACLR, 59 to optional delayed ACLR. Magnetic resonance imaging (MRI) was acquired within 4 weeks of injury, at two- and 5-years follow-up. Main outcome was 5-year change in overall femorotibial cartilage thickness. Secondary outcomes included the location-independent cartilage ChangeScore, summarizing thinning and thickening in 16 femorotibial subregions. An exploratory as-treated comparison was performed additionally. Results: Baseline and at least one follow-up MRI were available for 117 patients. Over 5 years, a comparable increase in overall femorotibial cartilage thickness was observed for patients randomized to early ACLR (n = 59) and patients randomized to optional delayed ACLR (n = 58, adjusted mean difference: −5 μm, 95% CI: [−118, 108]μm). However, the location-independent cartilage ChangeScore was greater in those treated with early ACLR than in patients treated with optional delayed ACLR (adjusted mean difference: 403 μm [119, 687]μm). As-treated analysis showed no between-group differences for the main outcome, while the location-independent cartilage ChangeScore was greater for patients treated with early (adjusted mean difference: 632 μm [268, 996]μm) or delayed ACLR (adjusted mean difference: 449 μm [108, 791]μm) than for patients treated with rehabilitation alone. Conclusions: In young active adults with acute ACL-injury, choice of treatment strategy for the injured ACL did not modify the magnitude of 5-year change in overall femorotibial cartilage thickness. Trial registration: ISRCTN84752559.
(Less)
- author
- Wirth, W.
; Eckstein, F.
; Culvenor, A. G.
; Hudelmaier, M. I.
; Stefan Lohmander, L.
LU
and Frobell, R. B.
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Anterior cruciate ligament, Cartilage, Knee, MRI, Osteoarthritis
- in
- Osteoarthritis and Cartilage
- volume
- 29
- issue
- 4
- pages
- 9 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85103487255
- pmid:33549723
- ISSN
- 1063-4584
- DOI
- 10.1016/j.joca.2021.01.004
- language
- English
- LU publication?
- yes
- id
- 7b8b376e-9ed2-4722-99f8-287656a74e51
- date added to LUP
- 2021-04-14 10:34:46
- date last changed
- 2025-01-26 09:07:05
@article{7b8b376e-9ed2-4722-99f8-287656a74e51,
abstract = {{<p>Objective: To compare 5-year change in femorotibial cartilage thickness in 121 young, active adults with an acute anterior cruciate ligament (ACL) tear randomized to a strategy of structured rehabilitation plus early ACL reconstruction (ACLR) or structured rehabilitation plus optional delayed ACLR. Design: 62 patients were randomized to early ACLR, 59 to optional delayed ACLR. Magnetic resonance imaging (MRI) was acquired within 4 weeks of injury, at two- and 5-years follow-up. Main outcome was 5-year change in overall femorotibial cartilage thickness. Secondary outcomes included the location-independent cartilage ChangeScore, summarizing thinning and thickening in 16 femorotibial subregions. An exploratory as-treated comparison was performed additionally. Results: Baseline and at least one follow-up MRI were available for 117 patients. Over 5 years, a comparable increase in overall femorotibial cartilage thickness was observed for patients randomized to early ACLR (n = 59) and patients randomized to optional delayed ACLR (n = 58, adjusted mean difference: −5 μm, 95% CI: [−118, 108]μm). However, the location-independent cartilage ChangeScore was greater in those treated with early ACLR than in patients treated with optional delayed ACLR (adjusted mean difference: 403 μm [119, 687]μm). As-treated analysis showed no between-group differences for the main outcome, while the location-independent cartilage ChangeScore was greater for patients treated with early (adjusted mean difference: 632 μm [268, 996]μm) or delayed ACLR (adjusted mean difference: 449 μm [108, 791]μm) than for patients treated with rehabilitation alone. Conclusions: In young active adults with acute ACL-injury, choice of treatment strategy for the injured ACL did not modify the magnitude of 5-year change in overall femorotibial cartilage thickness. Trial registration: ISRCTN84752559.</p>}},
author = {{Wirth, W. and Eckstein, F. and Culvenor, A. G. and Hudelmaier, M. I. and Stefan Lohmander, L. and Frobell, R. B.}},
issn = {{1063-4584}},
keywords = {{Anterior cruciate ligament; Cartilage; Knee; MRI; Osteoarthritis}},
language = {{eng}},
number = {{4}},
pages = {{518--526}},
publisher = {{Elsevier}},
series = {{Osteoarthritis and Cartilage}},
title = {{Early anterior cruciate ligament reconstruction does not affect 5 year change in knee cartilage thickness : secondary analysis of a randomized clinical trial}},
url = {{http://dx.doi.org/10.1016/j.joca.2021.01.004}},
doi = {{10.1016/j.joca.2021.01.004}},
volume = {{29}},
year = {{2021}},
}