Long-term knee function good after ligament repair
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People who have surgery to repair a common knee ligament injury show improvement in knee function as long as 15 years after undergoing the operation, new research shows.
Injuries to the anterior cruciate ligament (ACL), which links the thigh bone to the shin bone, are common among young people, and typically treated by repairing the ligament. But recent studies have suggested that for some people, intensive physical therapy to strengthen and stabilize the joint may be enough.
In the current study, Dr. Britt Elin Olestad of Oslo University Hospital Ulleval, Norway, and her colleagues investigated long-term knee function and osteoarthritis in 221 patients between 15 and 50 years old who were treated with ACL repair between 1990 and 1997—evaluating patients six months, one year, two years, and 10 to 15 years after the surgery.
Knee function improved over time based on every test the researchers used, including several different tests of knee stability, strength, and joint pain.
Patients who had additional knee injuries, for example tears in the cartilage between the thigh bone and shin bone at either side of the knee, had the same degree of improvement as the patients with ACL injuries only.
However, 30 percent of patients overall continued to have some impairment in knee function.
Eighty percent of the patients with combined injuries developed osteoarthritis of the knee as shown on X-rays, compared to 62 percent of the patients with ACL-only injury. Differences in the likelihood of having symptoms of arthritis in the knee such as pain and swelling—46 percent for patients with combined injuries, and 32 percent for patients with ACL injuries alone—were not statistically significant, meaning they could have been due to chance.
“This study showed,” the researchers conclude, “that the majority of persons with isolated and combined injuries seem to restore and maintain good, but not normal, knee function more than 10 years after the ACL reconstruction.”
SOURCE: American Journal of Sports Medicine, online August 16, 2010.
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