Daniel and colleagues followed patients with an acute traumatic knee hemarthrosis to describe their outcomes with and without ACL reconstruction and to identify early factors linked to later surgery.
Prospective cohort of 292 patients with acute traumatic hemarthrosis, grouped by early KT‑1000 stability and reconstruction timing, followed a mean of 64 months.
Methods
Design
Prospective cohort
Data source
San Diego Kaiser Medical Center
Patients
292 patients with acute traumatic hemarthrosis
KT‑1000 within 90 days: 56 stable, 236 unstable
Exposure
Group I: early stable, no reconstruction
Group II: early unstable, no reconstruction
Group III: ACL reconstruction within 90 days (45)
Group IV: ACL reconstruction after 90 days (46)
Follow-up
Mean 64 months
Range 46 to 113 months
Outcomes
Late meniscal or ACL surgery
Sports hours and level
Arthrosis on radiograph and bone scan
Change of occupation
Key Findings
Knees that underwent reconstruction showed more arthrosis on both radiograph and bone scan than knees left unreconstructed, in a nonrandomized cohort where patients chose their treatment.
The bone scan difference persisted among the 115 patients who never had meniscal surgery (p < 0.05).
Joint surface damage seen at surgery and meniscal surgery were each associated with higher radiograph and bone scan scores (p < 0.05).
Preinjury sports hours, arthrometer displacement and patient age correlated with late meniscal or ACL surgery (p < 0.05).
Early reconstruction appeared to protect the menisci, as only 2 of 45 early‑reconstruction patients (4%) needed late meniscal surgery.
Level I or II sport for 50 or more hours a year fell in every group, from over 85% before injury to 44% to 55% at follow‑up, reconstructed groups included.
Board pearl
At the first clinic visit, the KT‑1000 manual maximum test identified 96% of arthroscopically confirmed complete ACL tears, vs 68% for the 89‑N test.
Daniel and colleagues followed patients with an acute traumatic knee hemarthrosis to describe their outcomes with and without ACL reconstruction and to identify early factors linked to later surgery.
Prospective cohort of 292 patients with acute traumatic hemarthrosis, grouped by early KT‑1000 stability and reconstruction timing, followed a mean of 64 months.
Methods
Design
Prospective cohort
Data source
San Diego Kaiser Medical Center
Patients
292 patients with acute traumatic hemarthrosis
KT‑1000 within 90 days: 56 stable, 236 unstable
Exposure
Group I: early stable, no reconstruction
Group II: early unstable, no reconstruction
Group III: ACL reconstruction within 90 days (45)
Group IV: ACL reconstruction after 90 days (46)
Follow-up
Mean 64 months
Range 46 to 113 months
Outcomes
Late meniscal or ACL surgery
Sports hours and level
Arthrosis on radiograph and bone scan
Change of occupation
Key Findings
Knees that underwent reconstruction showed more arthrosis on both radiograph and bone scan than knees left unreconstructed, in a nonrandomized cohort where patients chose their treatment.
The bone scan difference persisted among the 115 patients who never had meniscal surgery (p < 0.05).
Joint surface damage seen at surgery and meniscal surgery were each associated with higher radiograph and bone scan scores (p < 0.05).
Preinjury sports hours, arthrometer displacement and patient age correlated with late meniscal or ACL surgery (p < 0.05).
Early reconstruction appeared to protect the menisci, as only 2 of 45 early‑reconstruction patients (4%) needed late meniscal surgery.
Level I or II sport for 50 or more hours a year fell in every group, from over 85% before injury to 44% to 55% at follow‑up, reconstructed groups included.
Board pearl
At the first clinic visit, the KT‑1000 manual maximum test identified 96% of arthroscopically confirmed complete ACL tears, vs 68% for the 89‑N test.