e4 2010 Asics Conference of Science and Medicine in Sport / Journal of Science and Medicine in Sport 13S (2010) e1–e107

grade (p = 0.19). ACL graft rupture occurred in 16% of HTgroup and 8% of the PT group (p = 0.10). Age, graft type andgender were not associated with ACL graft rupture. Contralat-eral ACL rupture occurred in significantly more PT patients(24%) than HT patients (12%) (p = 0.03), and was associatedwith age < 18 years and the patellar tendon graft. Conclu-sion: There were significant differences identified betweenthe groups at 15 years after surgery which were not seen atearlier reviews. The patellar tendon group had significantlyworse outcomes on subjective scores, range of motion andfunctional tests but no significant difference in laxity wasidentified. There was a high incidence of ACL re-injury afterreconstruction, to both the reconstructed and the contralateralknee.

doi:10.1016/j.jsams.2010.10.469

9

Hamstring tendon autograft does not protect thepatellofemoral joint from osteoarthritis after anteriorcruciate ligament reconstruction: 7 year follow-up

K. Crossley 1,∗, C. Lai 2, J. Lentzos 1, B. Gabbe 2, H.Morris 3, C. Tan 3, M. Pandy 1, P. Brukner 1, M. Makdissi 1

1 The University of Melbourne, Australia2 Monash University, Australia3 Private Practice, Australia

Introduction: Early tibiofemoral joint (TFJ) osteoarthri-tis (OA) frequently develops secondary to anterior cruciateligament reconstruction (ACLR). The few studies that haveevaluated patellofemoral joint (PFJ) reported a high preva-lence of PFJ OA (∼46%) >7 years post surgery. Notably,these studies only followed up people who had a patellartendon autograft, which is known to be associated with PFJmorbidity. This study aimed to: (i) describe the prevalence ofradiographic PFJ and TFJ OA, 7 years after ACLR using ahamstring tendon autograft (HT); (ii) compare OA symp-toms, anterior knee pain symptoms, ACLR outcome andactivity levels between people with PFJ OA and those whowere free of OA; and (iii) compare the range of knee motionand functional performance between people with PFJ OAand those with no OA. Methodology: 70 people with a HTACLR from a single surgeon 5–10 years previously wererecruited and performed: (i) standard radiographs (postero-anterior (PA) to grade the TFJ, skyline to grade the PFJ)(ii) questionnaires including the Knee Osteoarthrits OutcomeScore (KOOS), Anterior Knee Pain Scale (AKPS), TegnerActivity Scale, International Knee Documentation Commit-tee (IKDC) Subjective Knee Form, International PhysicalActivity Questionnaire; (iii) range of knee movement andfunctional performance examination. Results: Of 70 partici-pants, radiographic PFJ OA was evident in 47% (33/70) andradiographic TFJ OA was evident in 33% (23/70). In total,48% (34/70) exhibited no radiographic evidence of either

TFJ or PFJ OA. Of the 36 (51%) people with radiographicOA, isolated PFJ OA was the most common distribution(41%), followed by tri-compartmental distribution (31%),then lateral TFJ and PFJ distribution (13%) combined medialTFJ and PFJ (8%) and isolated TFJ (8%). Between-groupcomparisons revealed no differences age, height, weight oractivity level for people with PFJ OA than those with noradiographic OA. People with radiographic PFJ OA had sig-nificantly worse scores on the AKPS, IKDC and most scalesof the KOOS than those without OA. There was no differ-ence in the range of knee extension between those with PFJOA and those with no OA, but participants with PFJ OAperformed significantly worse on functional tests than thosewho were free of OA. Conclusion: PFJ OA is relatively com-mon ∼7 years after HT ACLR and is associated with worsesymptoms and reduced functional performance.

doi:10.1016/j.jsams.2010.10.470

10

Long term survival of high tibial osteotomy for medialosteoarthritis of the knee—8–19 year follow-up in a seriesof 455 patients

L. Pinczewski ∗, C. Hui, L. Salmon, A. Kok, H. Williams,N. Hockers, W. van der Tempel, R. Chana

North Sydney Orthopaedic and Sports Medicine Centre,Australia

Background: The management of degenerative arthritis ofthe knee in the younger, active patient presents a challenge tothe orthopaedic surgeon. Surgical treatment options include:high tibial osteotomy (HTO), unicompartmental knee arthro-plasty (UKA) and total knee arthroplasty (TKA). The aim ofthis study was to examine the long-term survival of closingwedge HTO in a large series of patients 8–19 years aftersurgery. Methods: The results of 455 consecutive patientsundergoing lateral closing wedge HTO for medial compart-ment osteoarthritis (MCOA) between 1990 and 2001 werereviewed. Between 2008 and 2009, patients were contactedvia telephone and assessment included: incidence of furthersurgery, body mass index (BMI), Oxford Knee Score, andBritish Orthopaedic Association (BOA) Patient SatisfactionScale. Failure was defined as the need for revision HTO orconversion to UKA or TKA. Survival analysis was completedusing the Kaplan–Meier method. Results: Four hundred andthirteen patients (91%) were contacted for follow-up via tele-phone interview. The probability of survival for HTO at5, 10 and 15 years was 95%, 79% and 56% respectively.Multivariate regression analysis showed that age < 50 years(p < 0.001) and BMI <25 kg/m2 (p = 0.03) were associatedwith better odds of survival. Mean Oxford Knee Score was40/48 (range 17–48). Ninety-three percent (252/272 patients)were enthusiastic or satisfied and 91% (247/272 patients)would undergo HTO again at mean 12 years follow-up. Con-