Editorial Commentary: Knee Lateral Extra-articular Tenodesis Procedures: Appropriate Study Design Is Essential for Reducing Conflicting Findings and Unnecessary Controversy in the Orthopaedic Literature.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosures The authors report the following potential conflicts of interest or sources of funding: B.S-C. receives royalties or licenses from Arthrex, consulting fees from Arthrex, support for attending meetings and/or travel from Arthrex, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Arthrex; has a leadership or fiduciary role with the French Arthroscopic Society and SANTI Study Group; has stock or stock options with AREAS; and is an editorial board member for OJSM. A.S. receives royalties or licenses from Convergence Medical, consulting fees from Arthrex, and support for attending meetings and/or travel from MacMedical and Arthroscopy Journal; has a leadership or fiduciary role with the ISAKOS Committees, AANA Committees, AAOS Committee, SANTI Study Group, and Maricopa County Medical Society; is an Editorial Board member for AJSM and OJSM; and is an Associate Editor for AANA (Arthroscopy Journal). All other authors (C.F. and T.D.V.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material. 15. Sports Med. 1999 Mar;27(3):143-56. doi: 10.2165/00007256-199927030-00001. Anterior cruciate ligament reconstruction and the long-term incidence of gonarthrosis. Gillquist J(1), Messner K. Author information: (1)Division of Sports Medicine, Faculty of Health Sciences, Linköping University, Sweden. Knee ligament injuries are common in sport. A rupture of the anterior cruciate ligament (ACL) is the most serious of these injuries because it may cause long term disability. In this literature review, the frequency of post-traumatic gonarthrosis is examined. There are few long term prospective studies but a number of retrospective studies with follow-up times between 5 and 20 years have been published. These studies show that radiographic gonarthrosis is significantly increased after all knee injuries compared with the uninjured joint of the same patient. Isolated meniscus rupture and subsequent repair, or partial or total ruptures of the ACL without major concomitant injuries, seem to increase the risk 10-fold (15 to 20% incidence of gonarthrosis) compared with an age-matched, uninjured population (1 to 2%). Meniscectomy in a joint with intact ligaments further doubles the risk of gonarthrosis (30 to 40%), and 50 to 70% of patients with complete ACL rupture and associated injuries have radiographic changes after 15 to 20 years. Thus, an ACL rupture combined with meniscus rupture or other knee ligament injuries results in gonarthrosis in most patients. Ten to 20 years after ACL injury, gonarthrosis often presents as a slight joint space reduction or, occasionally, joint space obliteration (Ahlbäck grades I to II), but is usually not associated with major clinical symptoms. According to the few longitudinal studies, the progress of gonarthrosis is slow, and in some cases the condition seems to remain stable. Time is an important determinant for the degree of gonarthrosis and problems demanding treatment may be encountered only at > 30 years after the initial accident. DOI: 10.2165/00007256-199927030-00001