The American journal of sports medicine · 2026 · 系統性回顧＋統合分析（依標題推測）
The Long-term Radiographic Fate of the Chronically ACL-Deficient Knee: A Systematic Review and Meta-analysis of Matched Cohort Studies
膝 · 前十字韌帶損傷
中文閱讀摘要
配對世代研究回顧顯示，慢性ACL缺損者中重度關節炎比例較重建者高，半月板切除與較嚴重退化相關。
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原始摘要
Background
Determining the long-term risk of arthritis in patients with anterior cruciate ligament (ACL) injury treated nonoperatively versus those who undergo ACL reconstruction (ACLR) remains an important and unanswered question for patients and surgeons.
Purpose
(1) To define the cumulative arthritis rate and severity after nonsurgical management of ACL injury-the chronically ACL-deficient (ACLD) knee; (2) to compare rates and severity of arthritis in patients who have ACLD knee with similar patients who underwent ACLR; and (3) to identify clinically relevant risk factors for arthritis.
Study design
Systematic review; Level of evidence, 3.
Methods
Three databases (Medline, Embase, PubMed) were searched for primary studies examining radiographic outcomes in patients with chronic ACL deficiency (>12 months of ACL deficiency). Studies with a matched ACLR control group were included. Quality assessment was performed with the MINORS (Methodological Index for Nonrandomized Studies) tool. Arthritis prevalence over time was plotted and modeled to best-fit using the Akaike information criterion. Data were extracted for meta-analysis for the primary outcome of osteoarthritis. The cumulative odds ratio of prognostic factors was calculated where appropriate.
Results
Nineteen full-text studies met inclusion criteria (11 matched cohort studies comparing ACLD and ACLR) including 1432 patients with a mean 11.1 years of follow-up after injury. The methodological quality of included studies was moderate. The pooled rate of radiographic arthritis in ACLD patients was 37.8%; the rate of moderate to severe arthritis was 18.1% (compared with 35.2% and 12.8% in patients with ACLR, respectively, and 5.0% in the nonoperated knee). An increase in the rate of arthritis was observed, accelerating sharply at 10 years after injury. ACLR and ACLD knees had similar prevalence of mild arthritis ( P = .60), irrespective of activity level. Joint degeneration was significantly accelerated by meniscectomy in ACLD patients in most studies.
Conclusion
Patients with a chronically ACLD knee may be at an increased predisposition for developing moderate to severe arthritis but not mild arthritis compared with matched patients who undergo ACLR. Meniscectomy is a key predictor of worsened severity of osteoarthritis.
至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19
書目、來源與全文狀態
- DOI
- 10.1177/03635465251405438
- PMID／PMCID
- 41572905 / PMC13279981
- 作者
- Shah A, Gumarathas K, Marks P, Marx RG, Kiss A, Wasserstein D
- 首次發表日期
- 2026-01-23Europe PMC 提供，部分日期可能依年份或月份推定。
- 卷／期／頁碼或文章編號
- 54 ／ 8 ／ 2021-2029
- 書目來源與查核日期
- Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
- 全文與授權
- 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。 來源授權標示：cc by。
可回溯引用
Shah A, Gumarathas K, Marks P, Marx RG, Kiss A, Wasserstein D. The Long-term Radiographic Fate of the Chronically ACL-Deficient Knee: A Systematic Review and Meta-analysis of Matched Cohort Studies. The American journal of sports medicine. 2026;54(8):2021-2029. PMID: 41572905. PMCID: PMC13279981. doi:10.1177/03635465251405438
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