PREDICTORS OF RADIOLOGICAL OSTEOARTHRITIS AT FIVE YEARS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Notice bibliographique
Résumé
To evaluate the predictive factors of post-traumatic knee osteoarthritis (OA) in the medial, lateral, and patellofemoral compartments at 5-years post-ACL reconstruction, within a large randomized clinical trial. Three-hundred-and-thirty patients (110 patients/group), ages 14–50 years, were randomized intra-operatively to ACL reconstruction with either a patellar tendon, single-bundle semitendinosus/gracilis tendon, or double-bundle semitendinosus and gracilis tendon autograft. Two- and 5-year clinical and quality-of-life outcomes have been previously published. Standardized radiographs (bilateral P-A weight-bearing, lateral, and bilateral skyline patella views) were performed on all patients at baseline, 2-years and 5-years follow-up. Radiographic OA was graded separately in the medial, lateral, and patellofemoral compartments, using the International Knee Documentation Committee (IKDC) radiographic grading scale. An independent, fellowship-trained orthopaedic surgeon graded the radiographs for absence (A–Normal, B–Nearly Normal) or presence (C–Abnormal, D–Severely Abnormal) of OA. Three separate multi-variable logistic regression analyses were performed with medial, lateral, and patellofemoral radiographic OA as the dependent outcome variable. The independent predictor variables included: demographics (age and sex), knee alignment, stability (Lachman and pivot shift tests), meniscal treatment and chondral condition at index surgery, graft type, graft failure, re-injury, and secondary surgery. A bivariate logistic regression was performed for each individual predictor. For each knee compartment, individual predictor variables with p<0.1 in a bivariate regression analysis were added to a multi-variable logistic regression model if the event rate was adequate. Odds ratios (OR) and 95% confidence intervals (95%CI) were reported. IKDC grades for radiographic OA were available for 302 patients (91.5%) at 5-years post-operative. Medial OA was assessed in 35 patients (10.6%). Varus alignment, medial meniscectomy, medial compartment chondral damage, age > 35 years and male sex were identified as individual predictors of radiographic OA. However, only medial meniscectomy (OR 5.8 (95%CI 2.7–12.6, p<0.01)) and varus knee alignment (OR 2.4 (95%CI 1.1–5.1; p=0.03)) significantly predicted medial OA. Lateral OA was assessed in 67 patients (20.3%). Graft type, pivot shift, valgus alignment, lateral meniscectomy, lateral meniscal repair, and lateral compartment chondral damage were identified as individual predictors of radiographic OA. However, only patellar tendon graft (OR 2.4 (95%CI 1.2–4.8 p=0.02)), lateral meniscectomy (OR 2.6 (95%CI 1.3–5.2, p≤0.01)), lateral meniscal repair (OR 3.3 (95%CI 1.5–7.4, p≤0.01)) and lateral compartment chondral damage (OR 2.0 (95%CI 1.0 – 3.9, p=0.04)) significantly predicted lateral OA. Based on a bivariate analysis with 9 patients (2.7%) with patellofemoral OA, only patellofemoral chondral damage (OR 5.7 (95%CI 1.5–21.8, p=0.01)) was a significant predictor of OA. Graft failure, traumatic re-injury, and secondary surgery did not predict presence of radiographic OA at 5-years post-operative in any compartment. Graft failure, traumatic re-injury, and secondary surgery did not predict presence of radiographic OA at 5-years post-operative in any compartment. At 5-years post-ACL reconstruction, varus alignment and medial meniscectomy significantly increase the risk of developing medial OA. Use of a patellar tendon graft, lateral meniscectomy, lateral meniscal repair, and chondral damage significantly increase the risk of developing lateral OA. Graft failure, traumatic re-injury, or secondary surgery were not predictive of radiographic OA in any compartment. Higher proportions of patients with OA are required to increase confidence in these associations.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».