{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T21:43:11Z","timestamp":1791063791100,"version":"4.1.0"},"reference-count":62,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,10,19]],"date-time":"2012-10-19T00:00:00Z","timestamp":1350604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Analysis of long\u2010term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4\u2010strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT\u20101000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X\u2010rays. Radiological classifications were according to Ahlb\u00e4ck and Kellgren &amp; Lawrence. Statistical analysis included univariate and multivariate logistic regressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p><jats:italic>Clinical outcome<\/jats:italic> A significant improvement (<jats:italic>p<\/jats:italic> &lt; 0.001) between preoperative and postoperative measurements could be demonstrated for the Lysholm and Tegner scores, IKDC patient subjective assessment, KT\u20101000\u00a0measurements, pivot shift test, IKDC score and one\u2010leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50 %) patients and correlated with lower levels of activity (<jats:italic>p<\/jats:italic> &lt; 0.022). Radiological outcome: At follow\u2010up, 46 (53.5 %) patients had signs of osteoarthritis (OA). In this group, 33 patients (72 %) had chondral lesions (\u2265grade 2) at the time of ACL reconstruction. A history of medial meniscectomy before or at the time of ACL reconstruction increased the risk of knee OA 4 times (95 % CI 1.41\u201311.5). An ICRS grade 3 at the time of ACL reconstruction increased the risk of knee OA by 5.2 times (95 % CI 1.09\u201324.8). There was no correlation between OA and activity level (Tegner score \u22656) nor between OA and a positive pivot shift test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transtibial ACL reconstruction with 4\u2010strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10\u2010year follow\u2010up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-2234-9","type":"journal-article","created":{"date-parts":[[2012,10,18]],"date-time":"2012-10-18T14:43:32Z","timestamp":1350571412000},"page":"1977-1988","source":"Crossref","is-referenced-by-count":91,"title":["Anterior cruciate ligament reconstruction with 4\u2010strand hamstring autograft and accelerated rehabilitation: a 10\u2010year prospective study on clinical results, knee osteoarthritis and its predictors"],"prefix":"10.1002","volume":"21","author":[{"given":"Rob P. 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