Institute of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway.
Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Br J Sports Med. 2019 Sep;53(18):1162-1167. doi: 10.1136/bjsports-2018-099751. Epub 2019 Apr 1.
This updated systematic review reports data from 2009 on the prevalence, and risk factors, for knee osteoarthritis (OA) more than 10 years after anterior cruciate ligament (ACL) tear.
We systematically searched five databases (PubMed, EMBASE, AMED, Cinahl and SPORTDiscus) for prospective and retrospective studies published after 1 August 2008. Studies were included if they investigated participants with ACL tear (isolated or in combination with medial collateral ligament and/or meniscal injuries) and reported symptomatic and/or radiographic OA at a minimum of 10 years postinjury. We used a modified version of the Downs and Black checklist for methodological quality assessment and narrative synthesis to report results. The study protocol was registered in PROSPERO.
Forty-one studies were included. Low methodological quality was revealed in over half of the studies. At inclusion, age ranged from 23 to 38 years, and at follow-up from 31 to 51 years. Sample sizes ranged from 18 to 780 participants. The reported radiographic OA prevalence varied between 0% and 100% >10 years after injury, regardless of follow-up time. The studies with low and high methodological quality reported a prevalence of radiographic OA between 0%-100% and 1%-80%, respectively. One study reported symptomatic knee OA for the tibiofemoral (TF) joint (35%), and one study reported symptomatic knee OA for the patellofemoral (PF) joint (15%). Meniscectomy was the only consistent risk factor determined from the data synthesis.
Radiographic knee OA varied between 0% and 100% in line with our previous systematic review from 2009. Symptomatic and radiographic knee OA was differentiated in two studies only, with a reported symptomatic OA prevalence of 35% for the TF joint and 15% for PF joint. Future cohort studies need to include measurement of symptomatic knee OA in this patient group.
CRD42016042693.
本系统评价更新版报告了 2009 年以后的研究数据，这些研究调查了前交叉韧带（ACL）撕裂 10 年以上后膝关节骨关节炎（OA）的患病率和危险因素。
我们系统地检索了五个数据库（PubMed、EMBASE、AMED、Cinahl 和 SPORTDiscus），以获取 2008 年 8 月 1 日后发表的前瞻性和回顾性研究。如果研究调查了 ACL 撕裂（单独或与内侧副韧带和/或半月板损伤合并）的参与者，并报告了至少 10 年后有症状和/或放射学 OA，则将这些研究纳入。我们使用 Downs 和 Black 清单的修改版本对方法学质量进行评估，并进行叙述性综合报告结果。研究方案已在 PROSPERO 中注册。
共纳入 41 项研究。超过一半的研究显示方法学质量较低。纳入时的年龄为 23-38 岁，随访时的年龄为 31-51 岁。样本量从 18 到 780 人不等。报告的放射学 OA 患病率在 ACL 损伤后 10 年以上从 0%到 100%不等，无论随访时间如何。方法学质量低和高的研究报告的放射学 OA 患病率分别为 0%-100%和 1%-80%。一项研究报告了髌股（PF）关节的有症状膝关节 OA（35%），另一项研究报告了髌股（TF）关节的有症状膝关节 OA（15%）。半月板切除术是从数据综合中确定的唯一一致的危险因素。
放射学膝关节 OA 的患病率在 0%到 100%之间，与我们 2009 年的系统评价一致。仅有两项研究对有症状和放射学膝关节 OA 进行了区分，报告的 TF 关节有症状 OA 患病率为 35%，PF 关节有症状 OA 患病率为 15%。未来的队列研究需要在该患者组中纳入对有症状膝关节 OA 的测量。
PROSPERO 注册号：CRD42016042693。
