SAN DIEGO — The incidence of osteoarthritis after ACL reconstruction is less when normal knee range of motion is achieved and maintained through follow-up, according to a presenter at the 2011 Annual Meeting of the American Orthopaedic Society for Sport Medicine here.
“Our results show little change of range of motion loss during the follow-up time. The data lead us to believe the range of motion deficits that patients have early after surgery persist throughout time and will contribute to osteoarthritis in the long-run,” K. Donald Shelbourne, MD said.
Shelbourne and colleagues prospectively followed patients after ACL reconstruction for a minimum of 5 years. Rehabilitation was refined through the years with the goal being to obtain full knee range of motion as quickly as possible after surgery and maintain it for the long-term. Range of motion and radiographs were evaluated according to IKDC objective criteria. Normal extension was considered to be within 2· of the opposite knee including hyperextension, and normal knee flexion was considered to be within 5·. Investigators rated radiographs as abnormal if they saw any sign of joint space narrowing of sclerosis or if osteophytes were present.
Postoperative follow-up was obtained for 780 patients at a mean of 10.5 ± 4.2 years with normal radiographs for 71% of those with normal extension and flexion and 55% of those with any range of motion deficit.
Of the patients with intact menisci, normal radiographs were found in 77% of cases with normal range of motion vs. 67% of cases with abnormal range of motion. For patients with medial meniscectomy, normal radiographs were found for 56% of patients with normal motion vs. 38% of patients with abnormal motion. For patients with lateral meniscectomy, normal radiographs were found for 74% of patients with normal range of motion vs. 41% for those with abnormal range of motion. For patients with both medial and lateral meniscectomy, normal radiographs were found for 56% of patients with normal motion compared to 24% of patients w
ho had abnormal range of motion.
“Patients with abnormal range of motion at follow-up after ACL reconstruction have twice the chance of developing osteoarthritis. Proper rehabilitation to achieve normal knee range of motion can reduce the effect of partial meniscectomy or articular cartilage damage for developing osteoarthritis after surgery,” Shelbourne said.
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