Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction

Adam G Culvenor, Courtney C H Lai, Belinda Jane Gabbe, Michael Makdissi, Natalie J Collins, Bill Vicenzino, Hayden Morris, Kay Crossley

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Abstract

Objectives To evaluate the compartmental distribution of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR), to determine if patellofemoral or tibiofemoral OA is more strongly associated with knee symptoms and function, and to evaluate the contribution of associated injuries and surgical delay to the development of OA. Methods This cross-sectional study recruited 70 participants who underwent hamstring tendon (HT) ACLR 5?10 years previously. Radiographic OA was assessed according to the Osteoarthritis Research Society International (OARSI) criteria. Knee symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Anterior Knee Pain Scale (AKPS), while function was assessed with three lower limb tasks (hop-for-distance, one-leg rise and side-hop). Multivariate and binary logistic regression analyses were performed to assess the relationship between OA and symptomatic/functional outcomes and associated injuries/ surgical delay, respectively. Results Radiographic OA was observed in the patellofemoral (47 ) and tibiofemoral joints (31 ). Pain, symptoms and quality of life on the KOOS and the AKPS were associated with severity of patellofemoral OA (standardised regression coefficient (?)=-0.3 to -0.5, p=0.001?0.042), whereas only the KOOS-pain subscale was associated with tibiofemoral OA (?=-0.3, p=0.037). For each functional task, greater patellofemoral OA severity was associated with worse performance, independent of tibiofemoral OA severity (?=-0.3 to -0.4, p=0.001?0.026). Medial meniscal and patellofemoral chondral lesions at surgery were associated with tibiofemoral and patellofemoral OA development at follow-up, respectively, while a longer surgery delay was associated with patellofemoral OA. Conclusions Patellofemoral OA is common following HT ACLR and is associated with worse knee-related symptoms, including anterior knee pain, and decreased functional performance.
Original languageEnglish
Pages (from-to)435 - 439
Number of pages5
JournalBritish Journal of Sports Medicine
Volume48
Issue number6
DOIs
Publication statusPublished - 2014

Cite this

Culvenor, Adam G ; Lai, Courtney C H ; Gabbe, Belinda Jane ; Makdissi, Michael ; Collins, Natalie J ; Vicenzino, Bill ; Morris, Hayden ; Crossley, Kay. / Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction. In: British Journal of Sports Medicine. 2014 ; Vol. 48, No. 6. pp. 435 - 439.
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title = "Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction",
abstract = "Objectives To evaluate the compartmental distribution of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR), to determine if patellofemoral or tibiofemoral OA is more strongly associated with knee symptoms and function, and to evaluate the contribution of associated injuries and surgical delay to the development of OA. Methods This cross-sectional study recruited 70 participants who underwent hamstring tendon (HT) ACLR 5?10 years previously. Radiographic OA was assessed according to the Osteoarthritis Research Society International (OARSI) criteria. Knee symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Anterior Knee Pain Scale (AKPS), while function was assessed with three lower limb tasks (hop-for-distance, one-leg rise and side-hop). Multivariate and binary logistic regression analyses were performed to assess the relationship between OA and symptomatic/functional outcomes and associated injuries/ surgical delay, respectively. Results Radiographic OA was observed in the patellofemoral (47 ) and tibiofemoral joints (31 ). Pain, symptoms and quality of life on the KOOS and the AKPS were associated with severity of patellofemoral OA (standardised regression coefficient (?)=-0.3 to -0.5, p=0.001?0.042), whereas only the KOOS-pain subscale was associated with tibiofemoral OA (?=-0.3, p=0.037). For each functional task, greater patellofemoral OA severity was associated with worse performance, independent of tibiofemoral OA severity (?=-0.3 to -0.4, p=0.001?0.026). Medial meniscal and patellofemoral chondral lesions at surgery were associated with tibiofemoral and patellofemoral OA development at follow-up, respectively, while a longer surgery delay was associated with patellofemoral OA. Conclusions Patellofemoral OA is common following HT ACLR and is associated with worse knee-related symptoms, including anterior knee pain, and decreased functional performance.",
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Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction. / Culvenor, Adam G; Lai, Courtney C H; Gabbe, Belinda Jane; Makdissi, Michael; Collins, Natalie J; Vicenzino, Bill; Morris, Hayden; Crossley, Kay.

In: British Journal of Sports Medicine, Vol. 48, No. 6, 2014, p. 435 - 439.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction

AU - Culvenor, Adam G

AU - Lai, Courtney C H

AU - Gabbe, Belinda Jane

AU - Makdissi, Michael

AU - Collins, Natalie J

AU - Vicenzino, Bill

AU - Morris, Hayden

AU - Crossley, Kay

PY - 2014

Y1 - 2014

N2 - Objectives To evaluate the compartmental distribution of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR), to determine if patellofemoral or tibiofemoral OA is more strongly associated with knee symptoms and function, and to evaluate the contribution of associated injuries and surgical delay to the development of OA. Methods This cross-sectional study recruited 70 participants who underwent hamstring tendon (HT) ACLR 5?10 years previously. Radiographic OA was assessed according to the Osteoarthritis Research Society International (OARSI) criteria. Knee symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Anterior Knee Pain Scale (AKPS), while function was assessed with three lower limb tasks (hop-for-distance, one-leg rise and side-hop). Multivariate and binary logistic regression analyses were performed to assess the relationship between OA and symptomatic/functional outcomes and associated injuries/ surgical delay, respectively. Results Radiographic OA was observed in the patellofemoral (47 ) and tibiofemoral joints (31 ). Pain, symptoms and quality of life on the KOOS and the AKPS were associated with severity of patellofemoral OA (standardised regression coefficient (?)=-0.3 to -0.5, p=0.001?0.042), whereas only the KOOS-pain subscale was associated with tibiofemoral OA (?=-0.3, p=0.037). For each functional task, greater patellofemoral OA severity was associated with worse performance, independent of tibiofemoral OA severity (?=-0.3 to -0.4, p=0.001?0.026). Medial meniscal and patellofemoral chondral lesions at surgery were associated with tibiofemoral and patellofemoral OA development at follow-up, respectively, while a longer surgery delay was associated with patellofemoral OA. Conclusions Patellofemoral OA is common following HT ACLR and is associated with worse knee-related symptoms, including anterior knee pain, and decreased functional performance.

AB - Objectives To evaluate the compartmental distribution of knee osteoarthritis (OA) after anterior cruciate ligament reconstruction (ACLR), to determine if patellofemoral or tibiofemoral OA is more strongly associated with knee symptoms and function, and to evaluate the contribution of associated injuries and surgical delay to the development of OA. Methods This cross-sectional study recruited 70 participants who underwent hamstring tendon (HT) ACLR 5?10 years previously. Radiographic OA was assessed according to the Osteoarthritis Research Society International (OARSI) criteria. Knee symptoms were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Anterior Knee Pain Scale (AKPS), while function was assessed with three lower limb tasks (hop-for-distance, one-leg rise and side-hop). Multivariate and binary logistic regression analyses were performed to assess the relationship between OA and symptomatic/functional outcomes and associated injuries/ surgical delay, respectively. Results Radiographic OA was observed in the patellofemoral (47 ) and tibiofemoral joints (31 ). Pain, symptoms and quality of life on the KOOS and the AKPS were associated with severity of patellofemoral OA (standardised regression coefficient (?)=-0.3 to -0.5, p=0.001?0.042), whereas only the KOOS-pain subscale was associated with tibiofemoral OA (?=-0.3, p=0.037). For each functional task, greater patellofemoral OA severity was associated with worse performance, independent of tibiofemoral OA severity (?=-0.3 to -0.4, p=0.001?0.026). Medial meniscal and patellofemoral chondral lesions at surgery were associated with tibiofemoral and patellofemoral OA development at follow-up, respectively, while a longer surgery delay was associated with patellofemoral OA. Conclusions Patellofemoral OA is common following HT ACLR and is associated with worse knee-related symptoms, including anterior knee pain, and decreased functional performance.

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DO - 10.1136/bjsports-2013-092975

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JO - British Journal of Sports Medicine

JF - British Journal of Sports Medicine

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