Long-term results of posterior cruciate ligament tear with or without reconstruction: A nationwide, population-based cohort study
There is increasing interest in the long-term outcomes of patients with posterior cruciate ligament (PCL) tears following conservative treatment or reconstruction. However, limited information is available regarding these results because of the relative rarity of cases and lack of long-term follow-u...
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| description | There is increasing interest in the long-term outcomes of patients with posterior cruciate ligament (PCL) tears following conservative treatment or reconstruction. However, limited information is available regarding these results because of the relative rarity of cases and lack of long-term follow-up.
The goals of this study are to (1) compare the occurrence of secondary meniscal tears, osteoarthritis (OA) or subsequent total knee replacement (TKR) in patients with or without PCL injury, and (2) evaluate the potential protective effect of PCL reconstruction against long-term sequela in patients with PCL deficiency.
Cohort study; Level of evidence, 3.
This retrospective cohort study evaluated the long-term results of PCL deficiency with or without reconstruction in Taiwan based on data from the National Health Insurance Research Database (NHIRD) from 2000 to 2015. The cumulative incidence rates of meniscus tear, OA and TKR were analyzed using the Kaplan-Meier estimator. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
A total of 4,169 patients diagnosed with PCL tear from 2000 to 2015 in Taiwan were included in the study. There was a higher cumulative incidence of meniscus tear (1.13%), OA (2.71%) and subsequent TKR (0.91%) among patients with a PCL tear than among patients without one (0.22%, 1.90%, 0.62%; all p < 0.05). PCL reconstruction patients had a decreased cumulative incidence of meniscus tear (0.41%), OA (2.30%) and subsequent TKR (0.48%) compared with non-reconstructed patients (2.44%, 3.46%, 1.69%; all p < 0.05). After adjusting for covariates, PCL-injured patients who underwent reconstruction within one year after PCL injury showed a significantly lower risk of subsequent sequelae than those who never underwent reconstruction (within 1 month: adjusted HR = 0.390, 95% CI = 0.284-0.535; 1 month to 1 year: adjusted HR = 0.546, 95% CI = 0.398-0.748).
Patients with PCL tears have a significantly higher risk of meniscus tear, OA and subsequent TKR than patients without PCL tears. PCL reconstruction could decrease the cumulative incidence of these outcomes. The results suggest that PCL-injured patients should undergo reconstruction as early as possible (within one year) to reduce the risk of further degeneration. |
| doi_str_mv | 10.1371/journal.pone.0205118 |
| format | Article |
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The goals of this study are to (1) compare the occurrence of secondary meniscal tears, osteoarthritis (OA) or subsequent total knee replacement (TKR) in patients with or without PCL injury, and (2) evaluate the potential protective effect of PCL reconstruction against long-term sequela in patients with PCL deficiency.
Cohort study; Level of evidence, 3.
This retrospective cohort study evaluated the long-term results of PCL deficiency with or without reconstruction in Taiwan based on data from the National Health Insurance Research Database (NHIRD) from 2000 to 2015. The cumulative incidence rates of meniscus tear, OA and TKR were analyzed using the Kaplan-Meier estimator. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
A total of 4,169 patients diagnosed with PCL tear from 2000 to 2015 in Taiwan were included in the study. There was a higher cumulative incidence of meniscus tear (1.13%), OA (2.71%) and subsequent TKR (0.91%) among patients with a PCL tear than among patients without one (0.22%, 1.90%, 0.62%; all p < 0.05). PCL reconstruction patients had a decreased cumulative incidence of meniscus tear (0.41%), OA (2.30%) and subsequent TKR (0.48%) compared with non-reconstructed patients (2.44%, 3.46%, 1.69%; all p < 0.05). After adjusting for covariates, PCL-injured patients who underwent reconstruction within one year after PCL injury showed a significantly lower risk of subsequent sequelae than those who never underwent reconstruction (within 1 month: adjusted HR = 0.390, 95% CI = 0.284-0.535; 1 month to 1 year: adjusted HR = 0.546, 95% CI = 0.398-0.748).
Patients with PCL tears have a significantly higher risk of meniscus tear, OA and subsequent TKR than patients without PCL tears. PCL reconstruction could decrease the cumulative incidence of these outcomes. The results suggest that PCL-injured patients should undergo reconstruction as early as possible (within one year) to reduce the risk of further degeneration.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0205118</identifier><identifier>PMID: 30281658</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Arthritis ; Arthroplasty ; Biocompatibility ; Biology and Life Sciences ; Biomedical materials ; Cohort analysis ; Complications ; Confidence intervals ; Degeneration ; Hazards ; Health aspects ; Health insurance ; Health risks ; Incidence ; Injuries ; Knee ; Medicine and Health Sciences ; Meniscus ; Osteoarthritis ; Patients ; Population studies ; Population-based studies ; Posterior cruciate ligament ; Reconstruction ; Risk ; Risk reduction ; Social Sciences ; Statistical models ; Studies ; Surgical implants ; Tearing ; Treatment outcome</subject><ispartof>PloS one, 2018-10, Vol.13 (10), p.e0205118-e0205118</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Wang et al 2018 Wang et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c653t-428c19cd280641ecdc3f880980a0e15dc91a9e3af4e3f53d7a39941e31d32ed53</citedby><cites>FETCH-LOGICAL-c653t-428c19cd280641ecdc3f880980a0e15dc91a9e3af4e3f53d7a39941e31d32ed53</cites><orcidid>0000-0001-9577-820X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169976/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6169976/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30281658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Sheng-Hao</creatorcontrib><creatorcontrib>Chien, Wu-Chien</creatorcontrib><creatorcontrib>Chung, Chi-Hsiang</creatorcontrib><creatorcontrib>Wang, Yung-Chih</creatorcontrib><creatorcontrib>Lin, Leou-Chyr</creatorcontrib><creatorcontrib>Pan, Ru-Yu</creatorcontrib><title>Long-term results of posterior cruciate ligament tear with or without reconstruction: A nationwide, population-based cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>There is increasing interest in the long-term outcomes of patients with posterior cruciate ligament (PCL) tears following conservative treatment or reconstruction. However, limited information is available regarding these results because of the relative rarity of cases and lack of long-term follow-up.
The goals of this study are to (1) compare the occurrence of secondary meniscal tears, osteoarthritis (OA) or subsequent total knee replacement (TKR) in patients with or without PCL injury, and (2) evaluate the potential protective effect of PCL reconstruction against long-term sequela in patients with PCL deficiency.
Cohort study; Level of evidence, 3.
This retrospective cohort study evaluated the long-term results of PCL deficiency with or without reconstruction in Taiwan based on data from the National Health Insurance Research Database (NHIRD) from 2000 to 2015. The cumulative incidence rates of meniscus tear, OA and TKR were analyzed using the Kaplan-Meier estimator. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
A total of 4,169 patients diagnosed with PCL tear from 2000 to 2015 in Taiwan were included in the study. There was a higher cumulative incidence of meniscus tear (1.13%), OA (2.71%) and subsequent TKR (0.91%) among patients with a PCL tear than among patients without one (0.22%, 1.90%, 0.62%; all p < 0.05). PCL reconstruction patients had a decreased cumulative incidence of meniscus tear (0.41%), OA (2.30%) and subsequent TKR (0.48%) compared with non-reconstructed patients (2.44%, 3.46%, 1.69%; all p < 0.05). After adjusting for covariates, PCL-injured patients who underwent reconstruction within one year after PCL injury showed a significantly lower risk of subsequent sequelae than those who never underwent reconstruction (within 1 month: adjusted HR = 0.390, 95% CI = 0.284-0.535; 1 month to 1 year: adjusted HR = 0.546, 95% CI = 0.398-0.748).
Patients with PCL tears have a significantly higher risk of meniscus tear, OA and subsequent TKR than patients without PCL tears. PCL reconstruction could decrease the cumulative incidence of these outcomes. The results suggest that PCL-injured patients should undergo reconstruction as early as possible (within one year) to reduce the risk of further degeneration.</description><subject>Analysis</subject><subject>Arthritis</subject><subject>Arthroplasty</subject><subject>Biocompatibility</subject><subject>Biology and Life Sciences</subject><subject>Biomedical materials</subject><subject>Cohort analysis</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Degeneration</subject><subject>Hazards</subject><subject>Health aspects</subject><subject>Health insurance</subject><subject>Health risks</subject><subject>Incidence</subject><subject>Injuries</subject><subject>Knee</subject><subject>Medicine and Health Sciences</subject><subject>Meniscus</subject><subject>Osteoarthritis</subject><subject>Patients</subject><subject>Population studies</subject><subject>Population-based studies</subject><subject>Posterior cruciate ligament</subject><subject>Reconstruction</subject><subject>Risk</subject><subject>Risk reduction</subject><subject>Social Sciences</subject><subject>Statistical models</subject><subject>Studies</subject><subject>Surgical implants</subject><subject>Tearing</subject><subject>Treatment 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risks</topic><topic>Incidence</topic><topic>Injuries</topic><topic>Knee</topic><topic>Medicine and Health Sciences</topic><topic>Meniscus</topic><topic>Osteoarthritis</topic><topic>Patients</topic><topic>Population studies</topic><topic>Population-based studies</topic><topic>Posterior cruciate ligament</topic><topic>Reconstruction</topic><topic>Risk</topic><topic>Risk reduction</topic><topic>Social Sciences</topic><topic>Statistical models</topic><topic>Studies</topic><topic>Surgical implants</topic><topic>Tearing</topic><topic>Treatment outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Sheng-Hao</creatorcontrib><creatorcontrib>Chien, Wu-Chien</creatorcontrib><creatorcontrib>Chung, Chi-Hsiang</creatorcontrib><creatorcontrib>Wang, Yung-Chih</creatorcontrib><creatorcontrib>Lin, Leou-Chyr</creatorcontrib><creatorcontrib>Pan, Ru-Yu</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In 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Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Sheng-Hao</au><au>Chien, Wu-Chien</au><au>Chung, Chi-Hsiang</au><au>Wang, Yung-Chih</au><au>Lin, Leou-Chyr</au><au>Pan, Ru-Yu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term results of posterior cruciate ligament tear with or without reconstruction: A nationwide, population-based cohort study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-10-03</date><risdate>2018</risdate><volume>13</volume><issue>10</issue><spage>e0205118</spage><epage>e0205118</epage><pages>e0205118-e0205118</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>There is increasing interest in the long-term outcomes of patients with posterior cruciate ligament (PCL) tears following conservative treatment or reconstruction. However, limited information is available regarding these results because of the relative rarity of cases and lack of long-term follow-up.
The goals of this study are to (1) compare the occurrence of secondary meniscal tears, osteoarthritis (OA) or subsequent total knee replacement (TKR) in patients with or without PCL injury, and (2) evaluate the potential protective effect of PCL reconstruction against long-term sequela in patients with PCL deficiency.
Cohort study; Level of evidence, 3.
This retrospective cohort study evaluated the long-term results of PCL deficiency with or without reconstruction in Taiwan based on data from the National Health Insurance Research Database (NHIRD) from 2000 to 2015. The cumulative incidence rates of meniscus tear, OA and TKR were analyzed using the Kaplan-Meier estimator. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
A total of 4,169 patients diagnosed with PCL tear from 2000 to 2015 in Taiwan were included in the study. There was a higher cumulative incidence of meniscus tear (1.13%), OA (2.71%) and subsequent TKR (0.91%) among patients with a PCL tear than among patients without one (0.22%, 1.90%, 0.62%; all p < 0.05). PCL reconstruction patients had a decreased cumulative incidence of meniscus tear (0.41%), OA (2.30%) and subsequent TKR (0.48%) compared with non-reconstructed patients (2.44%, 3.46%, 1.69%; all p < 0.05). After adjusting for covariates, PCL-injured patients who underwent reconstruction within one year after PCL injury showed a significantly lower risk of subsequent sequelae than those who never underwent reconstruction (within 1 month: adjusted HR = 0.390, 95% CI = 0.284-0.535; 1 month to 1 year: adjusted HR = 0.546, 95% CI = 0.398-0.748).
Patients with PCL tears have a significantly higher risk of meniscus tear, OA and subsequent TKR than patients without PCL tears. PCL reconstruction could decrease the cumulative incidence of these outcomes. The results suggest that PCL-injured patients should undergo reconstruction as early as possible (within one year) to reduce the risk of further degeneration.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30281658</pmid><doi>10.1371/journal.pone.0205118</doi><tpages>e0205118</tpages><orcidid>https://orcid.org/0000-0001-9577-820X</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2018-10, Vol.13 (10), p.e0205118-e0205118 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2117857363 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Analysis Arthritis Arthroplasty Biocompatibility Biology and Life Sciences Biomedical materials Cohort analysis Complications Confidence intervals Degeneration Hazards Health aspects Health insurance Health risks Incidence Injuries Knee Medicine and Health Sciences Meniscus Osteoarthritis Patients Population studies Population-based studies Posterior cruciate ligament Reconstruction Risk Risk reduction Social Sciences Statistical models Studies Surgical implants Tearing Treatment outcome |
| title | Long-term results of posterior cruciate ligament tear with or without reconstruction: A nationwide, population-based cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T02%3A02%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long-term%20results%20of%20posterior%20cruciate%20ligament%20tear%20with%20or%20without%20reconstruction:%20A%20nationwide,%20population-based%20cohort%20study&rft.jtitle=PloS%20one&rft.au=Wang,%20Sheng-Hao&rft.date=2018-10-03&rft.volume=13&rft.issue=10&rft.spage=e0205118&rft.epage=e0205118&rft.pages=e0205118-e0205118&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0205118&rft_dat=%3Cgale_plos_%3EA557683641%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2117857363&rft_id=info:pmid/30281658&rft_galeid=A557683641&rft_doaj_id=oai_doaj_org_article_589478d1485e4074bfcab13f22244efc&rfr_iscdi=true |