Long-term follow-up of ACL reconstruction: Insight into the natural history of altered biomechanics of the knee joint

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Gourlay, Robert
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The goal of ACL reconstruction is to restore stability to the knee joint and prevent the onset of osteoarthritis. Little is known of the long-term natural history of a knee joint that has undergone ACL reconstruction. Our study set out to investigate changes in the knee joint following ACL reconstruction. This retrospective study examined 68 participants who had received a semitendinosus/gracilis autograft ACL reconstruction a mean 14.6 years prior. Clinical evaluation involved radiographic analysis, IKDC knee examination form, instrumented laxity testing with the KT-1000 arthrometer, Tegner Activity Scale, Lysholm Knee Score, ACL QOL outcome questionnaire, and knee flexor/extensor strength testing using the Biodex III dynamometer. We observed increased incidence of OA in the reconstructed knee compared to the contralateral knee, especially in the medial compartment. Tegner Activity Score was reduced from the pre-injury level. We also report a significant decrease in knee extensor strength in the reconstructed knee compared to the contralateral knee. In conclusion, the semitendinosus/gracilis hamstring autograft showed an increased incidence of OA compared to contralateral knee, but a very good clinical outcome in the majority of patients.