Anterior Cruciate Ligament Rupture
Conditions
Keywords
Knee, Ligament, ACL, Reconstruction, Cartilage, Osteoarthritis
Brief summary
The anterior cruciate ligament (ACL) is one of four strong ligaments connecting the bones of the knee joint. If overstretched, the ACL can tear. Reconstruction of a torn ACL is now a common surgical procedure. The amount of tension applied to the ACL during reconstruction may indirectly affect the possible onset of arthritis over time. The purpose of this study is to determine the effect of initial graft tension set during ACL reconstruction surgery on the progression of knee arthritis over at least a 15-year period.
Detailed description
Damage to the ACL is a common injury that usually requires surgical reconstruction to restore function and prevent progression of post-traumatic osteoarthritis. However, the reconstruction procedure frequently causes degenerative changes to the knee joint over time. The amount of tension applied to the ACL during reconstruction may indirectly affect the possible onset of arthritis over time. High tension would result in less joint motion during the initial healing stages, which may make the onset of arthritis less likely. On the other hand, high tension would result in increased compressive forces between the joint surfaces, which could lead to arthritis. The purpose of this study is to evaluate the effect of initial graft tension set during ACL reconstruction surgery on joint cartilage and the development of knee arthritis over at least a 15-year period. Participants will include candidates for ACL reconstruction surgery using patellar tendon or hamstring tendon grafts. Participants will be randomly assigned to one of two treatment groups: * Low tension (Group 1) participants will receive low-tension treatment with initial graft tension set so that the anterior-posterior (A-P) displacement of the reconstructed knee is equal to that of the uninjured knee. * High-tension (Group 2) participants will receive high-tension treatment with initial graft tension set to reduce A-P displacement by 2 millimeters relative to that of the uninjured knee. Participants will enroll in this 15-year study 1 to 6 weeks prior to ACL surgery. There will be two preoperative study visits: one will include magnetic resonance imaging (MRI) and the other will include a knee evaluation, dynamic function testing, and questionnaires. Postoperative visits occurred immediately following surgery and at 6, 12, 36, 60, 84, 120, 144 and 180 months following surgery. Strength testing, functional testing, x-rays, questionnaires, and a knee exam will occur at most postoperative visits. MRIs will occur at some postoperative visits. An additional group of participants with no evidence of knee injury will serve as a control. The control group will attend all study visits except for the 12-month visit. All participants may be followed for up to 15 years.
Interventions
PROCEDUREInitial graft tension during ACL reconstruction surgery
The amount of tension that is applied to the graft at the time of fixation is being performed with the knee in two different positions. When the knee is at 30 degrees of flexion, the resulting laxity is approximately 2 mm less than the contralateral leg (the "High Tension" treatment). When the tension is performed with the knee in extension (0 degrees of flexion), the the laxity is equal to that of the contralateral leg (the "Low Tension" treatment). Both methods are commonly used in clinical practice. The effect it may have on articular cartilage remains unknown.
Sponsors
Rhode Island Hospital
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
15 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
for Groups 1 and 2: * ACL injury of only one knee (minor meniscal tears involving less than 1/3 of the meniscus are allowed) * Candidate for ACL reconstruction surgery using a bone-patellar tendon-bone graft or a four-stranded hamstring tendon graft (looped semitendinosus and gracilis muscles) * Tegner activity score of 5 or greater, indicating participant is at least moderately active
Exclusion criteria
for Groups 1 and 2: * ACL tear that has occurred more than 12 months prior to surgery * Moderate-sized fissures or lesions in knee articular cartilage * Meniscal tears requiring partial removal of meniscus (tears larger than 1/3 of the meniscus) Inclusion Criteria for the Control Group: * Tegner activity score of 5 or greater, indicating participant is at least moderately active
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Joint Space Narrowing (Kiapour Method) | 15 years | Joint space width measurements in the medial compartment were calculated from weightbearing radiographs using the semi-flexed metatarsophalangeal view. Radiographs were manually segmented to outline articular surfaces of femur and tibia using Mimics. A custom program in MATLAB developed by Dr. Ata Kiapour was used to calculate joint space width as the perpendicular distance between the femoral condyle and tibial plateau boundaries at 25% of total bicondylar width. Measured JSW values were then scaled using image distances between beads of a calibration standard taped to the fibular head. This method was used for the baseline, 10-12, and 15-year follow-up as a comparable in-house method to the surface-fit method. Subjects are identified as having radiographic signs of OA if they exhibit a change in the medial or lateral compartments greater than 0.30 mm over the study period. |
| Radiographic Joint Space Narrowing (Midpoint Method) | 3 years | Medial joint space width measurements were obtained from radiographs preoperatively and postoperatively using the semiflexed metatarsophalangeal view. Radiographs were taken of each knee, and the medial compartment joint space width was measured by calculating the distance between the femoral and tibial intersections with the bisecting midpoint line. Analysis was conducted using a MATLAB program. (Mehta N, Duryea J, Badger GJ, et al. Comparison of 2 Radiographic Techniques for Measurement of Tibiofemoral Joint Space Width. Orthop J Sports Med. 2017;5(9):2325967117728675. Published 2017 Sep 26. doi:10.1177/2325967117728675) Subjects are identified as having radiographic signs of OA if they exhibit a change in the medial or lateral compartments greater than 0.30 mm over the study period. This was the first method used for the study. It was used for baseline and 3-year follow-up prior to switching to the 'surface-fit' method at the 7-year follow-up. |
| Radiographic Joint Space Narrowing (Surface-Fit Method) | 7 years | Medial joint space width measurements were obtained from radiographs preoperatively and postoperatively using the semiflexed metatarsophalangeal view. Radiographs were taken of each knee, and the medial compartment joint space width was measured at the midline of the compartment in the coronal plane using a validated computer algorithm. (Duryea et al., Trainable rule-based algorithm for the measurement of joint space width in digital radiographic images of the knee, Medical Physics 27, 580 (2000); doi: 10.1118/1.598897). Subjects are identified as having radiographic signs of OA if they exhibit a change in the medial or lateral compartments greater than 0.30mm over the study period. The surface-fit method was used for the 7-year follow-up and baseline radiographs instead of the Midpoint Method, after confirming less variability across knees within a participant. (Mehta et al. 2017) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 15 years | The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 15 years | The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 15 years | The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems. |
| Knee Joint Laxity | 15 years | Difference in Anterior-Posterior (A-P) knee laxity value; A-P laxity is defined as the amount of A-P directed translation of the tibia (relative to the femur) between the shear load limits of -90 N (posterior) and 133 N (anterior). |
| Limb Strength International Knee Documentation Committee (IKDC) Score | 15 years | Clinical outcome was assessed using the 2000 IKDC Knee Examination Score (http://www.sportsmed.org). The IKDC scores evaluate 4 categories: function, symptoms, range of knee motion, and clinical examination.The IKDC score rates knees as normal (A), nearly normal (B), abnormal (C), and severely abnormal (D), with the final IKDC rating based on the score of the worst category. |
| Short Form-36 (SF-36) Health Survey Physical Functioning | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey Physical Role | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey General Health | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey Bodily Pain | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey Vitality | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey Social Function | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey Emotional Role | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Short Form-36 (SF-36) Health Survey Mental Health | 15 years | The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems. |
| Whole Organ Magnetic Resonance Image Score (WORMS) | 15 years | The OA status of the knee was assessed using the semiquantitative Whole Organ Magnetic Resonance Imaging Score (WORMS).The score uses magnetic resonance imaging (MRI) sequences to grade 14 independent features: cartilage signal and morphological characteristics, subarticular bone marrow abnormality, subarticular cysts, subarticular bone attrition, and marginal osteophytes evaluated in 15 regions. The condition of the menisci, cruciate and collateral ligaments, synovitis, loose bodies, and periarticular cysts was also included for a total possible score of 332 points. 0-indicates no damage in anatomical landmarks assessed. 332-severe damage to the anatomical landmarks assessed. |
| One-legged Hop Test | 15 years | Ratio of hop distance on the injured knee to the hop distance on the contralateral uninjured knee. |
| Modified OsteoArthritis Research Society International (OARSI) Score | 15 years | OARSI-The overall condition of the knee joints of both surgical and contralateral limbs were graded on radiographs by a radiologist. (0-83). 83-severe damage.0- no damage. The difference of the score between surgical and contralateral limbs is also presented. |
| Isokinetic Strength | 7 years | Strength of quadriceps muscles was quantified by averaging the peak torques of 3 repetitions and normalizing these values with respect to body weight.Percent torque of surgical compared to contralateral is presented. If the quadriceps muscle of the surgical limb had the same peak torque as the contralateral, it would be 100%. |
| Muscle Atrophy | 15 years | Thigh circumference 6 cm above the joint line for injured and contralateral knees. Muscle atrophy difference calculated as index-contralateral circumference. |
| Tegner Activity Scale | 15-years | The Tegner activity scale graded activity level based on work and sports activity on a scale of 1-10 with 1 representing physical disability due to knee problems and 10 indicating national or international level soccer participation. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 15 years | The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems. |
| Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 15 years | The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORBraden C. Fleming, PhD
Rhode Island Hospital/Brown Medical School
Participant flow
Recruitment details
Recruitment took place between February 2004 and February 2007 in clinics of participating doctors: Dr. Paul D. Fadale, Dr. Michael J. Hulstyn, and Dr. Robert M. Shalvoy.
Pre-assignment details
Patients between the age of 15-50 with isolated unilateral ACL injuries were considered for eligibility. Patients were excluded from the study if they required meniscectomy greater than 1/3 of meniscus, showed increased laxity of knee ligaments, or had a history of previous knee injuries and/or developing osteoarthritis. Of 108 subjects initially recruited to tension groups, 18 were excluded pre- or during surgery.
Participants by arm
| Arm | Count |
|---|---|
| Low-tension Patients recruited to study the initial graft tension during ACL reconstruction surgery who were randomized to the Low-tension group will receive the low-tension treatment with initial graft tension set so that the anterior-posterior (A-P) displacement of the reconstructed knee is equal to that of the uninjured knee.
Initial graft tension during ACL reconstruction surgery: The amount of tension that is applied to the graft at the time of fixation is being performed with the knee in two different positions. When the knee is at 30 degrees of flexion, the resulting laxity is approximately 2 mm less than the contralateral leg (the High Tension treatment). When the tension is performed with the knee in extension (0 degrees of flexion), the the laxity is equal to that of the contralateral leg (the Low Tension treatment). Both methods are commonly used in clinical practice. The effect it may have on articular cartilage remains unknown. | 46 |
| High-tension Patients recruited to study the initial graft tension during ACL reconstruction surgery who were randomized to the High-tension group will receive the high-tension treatment with the initial graft tension set to reduce A-P displacement by 2 millimeters relative to that of the uninjured knee.
Initial graft tension during ACL reconstruction surgery: The amount of tension that is applied to the graft at the time of fixation is being performed with the knee in two different positions. When the knee is at 30 degrees of flexion, the resulting laxity is approximately 2 mm less than the contralateral leg (the High Tension treatment). When the tension is performed with the knee in extension (0 degrees of flexion), the the laxity is equal to that of the contralateral leg (the Low Tension treatment). Both methods are commonly used in clinical practice. The effect it may have on articular cartilage remains unknown. | 44 |
| Uninjured Control Group Uninjured age, sex, and race matched control group | 60 |
| Total | 150 |
Baseline characteristics
| Characteristic | Low-tension | Total | Uninjured Control Group | High-tension |
|---|---|---|---|---|
| Age, Continuous | 23.9 years STANDARD_DEVIATION 9.26 | 24.2 years STANDARD_DEVIATION 7.53 | 25.3 years STANDARD_DEVIATION 6.15 | 23.1 years STANDARD_DEVIATION 7.19 |
| BMI | 24.7 kg/m^2 STANDARD_DEVIATION 3.2 | 24.3 kg/m^2 STANDARD_DEVIATION 3.28 | 23.9 kg/m^2 STANDARD_DEVIATION 3.14 | 24.5 kg/m^2 STANDARD_DEVIATION 3.56 |
| Graft type Autologous Hamstring Tendon | 15 Participants | 32 Participants | — | 17 Participants |
| Graft type Autologous Patellar Tendon | 31 Participants | 58 Participants | — | 27 Participants |
| Race/Ethnicity, Customized Asian | 0 participants | 5 participants | 3 participants | 2 participants |
| Race/Ethnicity, Customized Black | 0 participants | 3 participants | 1 participants | 2 participants |
| Race/Ethnicity, Customized Hispanic or Latino | 2 participants | 8 participants | 3 participants | 3 participants |
| Race/Ethnicity, Customized More than one race | 0 participants | 1 participants | 0 participants | 1 participants |
| Race/Ethnicity, Customized Native Hawaiian or Other Pacific Islander | 0 participants | 0 participants | 0 participants | 0 participants |
| Race/Ethnicity, Customized Unknown/Not Reported | 1 participants | 2 participants | 1 participants | 0 participants |
| Race/Ethnicity, Customized White | 43 participants | 131 participants | 52 participants | 36 participants |
| Region of Enrollment United States | 46 participants | 150 participants | 60 participants | 44 participants |
| Sex: Female, Male Female | 22 Participants | 74 Participants | 26 Participants | 26 Participants |
| Sex: Female, Male Male | 24 Participants | 76 Participants | 34 Participants | 18 Participants |
| Time from injury to surgery | 112 days STANDARD_DEVIATION 86.5 | 114 days STANDARD_DEVIATION 102 | — | 116 days STANDARD_DEVIATION 119 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 46 | 0 / 44 | 0 / 60 |
| other Total, other adverse events | 11 / 46 | 20 / 44 | 6 / 60 |
| serious Total, serious adverse events | 0 / 46 | 0 / 44 | 0 / 60 |
Outcome results
Primary
Radiographic Joint Space Narrowing (Kiapour Method)
Joint space width measurements in the medial compartment were calculated from weightbearing radiographs using the semi-flexed metatarsophalangeal view. Radiographs were manually segmented to outline articular surfaces of femur and tibia using Mimics. A custom program in MATLAB developed by Dr. Ata Kiapour was used to calculate joint space width as the perpendicular distance between the femoral condyle and tibial plateau boundaries at 25% of total bicondylar width. Measured JSW values were then scaled using image distances between beads of a calibration standard taped to the fibular head. This method was used for the baseline, 10-12, and 15-year follow-up as a comparable in-house method to the surface-fit method. Subjects are identified as having radiographic signs of OA if they exhibit a change in the medial or lateral compartments greater than 0.30 mm over the study period.
Time frame: 15 years
Population: Insufficient time for imaging; loss to follow-up. Method was used retroactively for existing baseline images.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Radiographic Joint Space Narrowing (Kiapour Method) | 10-12-year | -0.1038 mm |
| Low-tension | Radiographic Joint Space Narrowing (Kiapour Method) | Baseline | -0.1076 mm |
| Low-tension | Radiographic Joint Space Narrowing (Kiapour Method) | 15-year | 0.1136 mm |
| High-tension | Radiographic Joint Space Narrowing (Kiapour Method) | 10-12-year | 0.3238 mm |
| High-tension | Radiographic Joint Space Narrowing (Kiapour Method) | Baseline | 0.0653 mm |
| High-tension | Radiographic Joint Space Narrowing (Kiapour Method) | 15-year | 0.5509 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Kiapour Method) | Baseline | -0.0876 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Kiapour Method) | 15-year | -0.1553 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Kiapour Method) | 10-12-year | 0.3269 mm |
Comparison: These results are from the 15-year analysis.p-value: 0.22ANOVA
Primary
Radiographic Joint Space Narrowing (Midpoint Method)
Medial joint space width measurements were obtained from radiographs preoperatively and postoperatively using the semiflexed metatarsophalangeal view. Radiographs were taken of each knee, and the medial compartment joint space width was measured by calculating the distance between the femoral and tibial intersections with the bisecting midpoint line. Analysis was conducted using a MATLAB program. (Mehta N, Duryea J, Badger GJ, et al. Comparison of 2 Radiographic Techniques for Measurement of Tibiofemoral Joint Space Width. Orthop J Sports Med. 2017;5(9):2325967117728675. Published 2017 Sep 26. doi:10.1177/2325967117728675) Subjects are identified as having radiographic signs of OA if they exhibit a change in the medial or lateral compartments greater than 0.30 mm over the study period. This was the first method used for the study. It was used for baseline and 3-year follow-up prior to switching to the 'surface-fit' method at the 7-year follow-up.
Time frame: 3 years
Population: Insufficient time for imaging; loss to follow-up.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Radiographic Joint Space Narrowing (Midpoint Method) | 1-year | 0.1374 mm |
| Low-tension | Radiographic Joint Space Narrowing (Midpoint Method) | Baseline | 0.0613 mm |
| Low-tension | Radiographic Joint Space Narrowing (Midpoint Method) | 3-years | 0.0705 mm |
| High-tension | Radiographic Joint Space Narrowing (Midpoint Method) | 1-year | 0.1941 mm |
| High-tension | Radiographic Joint Space Narrowing (Midpoint Method) | Baseline | 0.0634 mm |
| High-tension | Radiographic Joint Space Narrowing (Midpoint Method) | 3-years | 0.0192 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Midpoint Method) | Baseline | -0.0321 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Midpoint Method) | 3-years | -0.1321 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Midpoint Method) | 1-year | -0.2413 mm |
Comparison: These results are from the 3-year analysis.p-value: 0.27ANOVA
Primary
Radiographic Joint Space Narrowing (Surface-Fit Method)
Medial joint space width measurements were obtained from radiographs preoperatively and postoperatively using the semiflexed metatarsophalangeal view. Radiographs were taken of each knee, and the medial compartment joint space width was measured at the midline of the compartment in the coronal plane using a validated computer algorithm. (Duryea et al., Trainable rule-based algorithm for the measurement of joint space width in digital radiographic images of the knee, Medical Physics 27, 580 (2000); doi: 10.1118/1.598897). Subjects are identified as having radiographic signs of OA if they exhibit a change in the medial or lateral compartments greater than 0.30mm over the study period. The surface-fit method was used for the 7-year follow-up and baseline radiographs instead of the Midpoint Method, after confirming less variability across knees within a participant. (Mehta et al. 2017)
Time frame: 7 years
Population: Insufficient time for imaging; loss to follow-up. Baseline images of subjects presented at 7-year follow-up were analyzed again retroactively with this method.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Radiographic Joint Space Narrowing (Surface-Fit Method) | Baseline | 0.1483 mm |
| Low-tension | Radiographic Joint Space Narrowing (Surface-Fit Method) | 7-years | 0.1858 mm |
| High-tension | Radiographic Joint Space Narrowing (Surface-Fit Method) | Baseline | 0.0029 mm |
| High-tension | Radiographic Joint Space Narrowing (Surface-Fit Method) | 7-years | 0.1969 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Surface-Fit Method) | Baseline | -0.0492 mm |
| Uninjured Control Group | Radiographic Joint Space Narrowing (Surface-Fit Method) | 7-years | -0.2314 mm |
Comparison: These results are from the 7-year analysis.p-value: 0.08ANOVA
Secondary
Isokinetic Strength
Strength of quadriceps muscles was quantified by averaging the peak torques of 3 repetitions and normalizing these values with respect to body weight.Percent torque of surgical compared to contralateral is presented. If the quadriceps muscle of the surgical limb had the same peak torque as the contralateral, it would be 100%.
Time frame: 7 years
Population: At baseline, machine measuring isokinetic strength was unavailable for many surgical subjects. Population discrepancies at later time-points include loss to follow-up and machine unavailability. Isokinetic strength was no longer measured after the 7-year follow-up.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Isokinetic Strength | Baseline | 80.0994 percentage of index/contralateral limbs |
| Low-tension | Isokinetic Strength | 1-year | 86.6887 percentage of index/contralateral limbs |
| Low-tension | Isokinetic Strength | 3-years | 94.4971 percentage of index/contralateral limbs |
| Low-tension | Isokinetic Strength | 7-years | 99.6495 percentage of index/contralateral limbs |
| High-tension | Isokinetic Strength | 7-years | 103.1218 percentage of index/contralateral limbs |
| High-tension | Isokinetic Strength | Baseline | 74.6156 percentage of index/contralateral limbs |
| High-tension | Isokinetic Strength | 3-years | 94.4971 percentage of index/contralateral limbs |
| High-tension | Isokinetic Strength | 1-year | 82.6245 percentage of index/contralateral limbs |
| Uninjured Control Group | Isokinetic Strength | 7-years | 99.9448 percentage of index/contralateral limbs |
| Uninjured Control Group | Isokinetic Strength | 1-year | 105.7979 percentage of index/contralateral limbs |
| Uninjured Control Group | Isokinetic Strength | 3-years | 102.3595 percentage of index/contralateral limbs |
| Uninjured Control Group | Isokinetic Strength | Baseline | 101.8830 percentage of index/contralateral limbs |
Comparison: These results were from the 7-year analysis.p-value: 0.54ANOVA
Secondary
Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life
The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the ADL score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 1-year | 94.5440 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 3-years | 94.5151 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | Baseline | 85.7680 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 6 months | 94.8097 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 7-years | 94.8938 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 15-years | 94.4005 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 10-12-years | 95.7313 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 6 months | 90.5462 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 10-12-years | 94.2263 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 15-years | 97.6190 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 1-year | 95.0415 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | Baseline | 84.3365 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 3-years | 95.8478 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 7-years | 96.5686 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 15-years | 99.0686 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | Baseline | 99.9755 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 1-year | 99.5037 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 3-years | 98.6779 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 7-years | 98.6592 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Activities of Daily Life | 10-12-years | 99.4094 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.015ANOVA
Secondary
Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain
The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the pain score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 1-year | 90.2317 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 3-years | 90.6907 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | Baseline | 75.3549 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 6 months | 86.6422 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 7-years | 90.5671 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 15-years | 90.7051 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 10-12-years | 90.8606 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 6 months | 86.2302 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 10-12-years | 91.0493 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 15-years | 93.5185 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 1-year | 88.9245 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | Baseline | 77.0187 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 3-years | 91.0948 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 7-years | 92.8241 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 15-years | 98.1481 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | Baseline | 98.8889 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 1-year | 98.1679 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 3-years | 96.2963 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 7-years | 96.3848 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Pain | 10-12-years | 97.3806 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.0018ANOVA
Secondary
Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life
The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the QOL score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 1-year | 74.0612 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 3-years | 78.8851 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | Baseline | 35.6944 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 6 months | 61.2132 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 7-years | 75.6944 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 15-years | 81.9712 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 10-12-years | 85.2823 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 6 months | 58.1250 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 10-12-years | 77.7778 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 15-years | 75.5952 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 1-year | 67.6282 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | Baseline | 37.9360 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 3-years | 77.7674 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 7-years | 81.2500 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 15-years | 94.7917 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | Baseline | 97.3517 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 1-year | 95.4122 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 3-years | 93.2692 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 7-years | 92.4632 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Quality of Life | 10-12-years | 94.2857 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.0006ANOVA
Secondary
Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport
The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the sport score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 1-year | 79.5708 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 3-years | 81.6216 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | Baseline | 54.7866 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 6 months | 75.7059 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 7-years | 80.0000 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 15-years | 80.5769 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 10-12-years | 85.0000 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 6 months | 73.9286 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 10-12-years | 85.7407 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 15-years | 87.3810 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 1-year | 80.3846 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | Baseline | 54.8882 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 3-years | 83.2353 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 7-years | 87.7778 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 15-years | 95.0000 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | Baseline | 98.0720 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 1-year | 95.9575 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 3-years | 92.6923 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 7-years | 93.6765 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Sport | 10-12-years | 94.0000 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.003ANOVA
Secondary
Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms
The five dimensions of Knee Osteoarthritis Outcome Score were scored separately: pain , symptoms ,activities of daily life function, sport and recreation function, and knee-related quality of life . Each sub score has a 0-100 scale. 0- extreme knee problems and 100- no knee problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the symptoms score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 1-year | 84.1270 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 3-years | 85.9073 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | Baseline | 70.3704 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 6 months | 79.5168 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 7-years | 82.2421 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 15-years | 84.2033 score on a scale |
| Low-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 10-12-years | 83.4110 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 6 months | 78.4184 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 10-12-years | 85.0257 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 15-years | 83.1633 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 1-year | 80.0824 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | Baseline | 70.4319 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 3-years | 82.1429 score on a scale |
| High-tension | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 7-years | 85.8135 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 15-years | 92.6190 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | Baseline | 96.7292 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 1-year | 95.8207 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 3-years | 93.2234 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 7-years | 92.3319 score on a scale |
| Uninjured Control Group | Knee Injury and Osteoarthritis Outcome Score (KOOS) - Symptoms | 10-12-years | 91.7351 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.0078ANOVA
Secondary
Knee Joint Laxity
Difference in Anterior-Posterior (A-P) knee laxity value; A-P laxity is defined as the amount of A-P directed translation of the tibia (relative to the femur) between the shear load limits of -90 N (posterior) and 133 N (anterior).
Time frame: 15 years
Population: Loss to follow-up or questionnaire-only participant
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Knee Joint Laxity | 10-12-years | 1.0763 Millimeters |
| Low-tension | Knee Joint Laxity | 1-year | 2.3026 Millimeters |
| Low-tension | Knee Joint Laxity | 15-years | .9907 Millimeters |
| Low-tension | Knee Joint Laxity | 3-years | 1.7727 Millimeters |
| Low-tension | Knee Joint Laxity | Baseline | 4.5107 Millimeters |
| Low-tension | Knee Joint Laxity | 7-years | 1.3436 Millimeters |
| Low-tension | Knee Joint Laxity | 6-months | 1.6605 Millimeters |
| High-tension | Knee Joint Laxity | Baseline | 4.1532 Millimeters |
| High-tension | Knee Joint Laxity | 10-12-years | 1.7086 Millimeters |
| High-tension | Knee Joint Laxity | 7-years | 1.3890 Millimeters |
| High-tension | Knee Joint Laxity | 3-years | 2.4545 Millimeters |
| High-tension | Knee Joint Laxity | 15-years | 1.5967 Millimeters |
| High-tension | Knee Joint Laxity | 6-months | 0.8389 Millimeters |
| High-tension | Knee Joint Laxity | 1-year | 2.1378 Millimeters |
| Uninjured Control Group | Knee Joint Laxity | 15-years | 1.1002 Millimeters |
| Uninjured Control Group | Knee Joint Laxity | Baseline | 0.4383 Millimeters |
| Uninjured Control Group | Knee Joint Laxity | 1-year | 0.1417 Millimeters |
| Uninjured Control Group | Knee Joint Laxity | 3-years | -0.8919 Millimeters |
| Uninjured Control Group | Knee Joint Laxity | 7-years | -0.3301 Millimeters |
| Uninjured Control Group | Knee Joint Laxity | 10-12-years | -0.0328 Millimeters |
Comparison: These results are from the 15-year analysis.p-value: 0.15ANOVA
Secondary
Limb Strength International Knee Documentation Committee (IKDC) Score
Clinical outcome was assessed using the 2000 IKDC Knee Examination Score (http://www.sportsmed.org). The IKDC scores evaluate 4 categories: function, symptoms, range of knee motion, and clinical examination.The IKDC score rates knees as normal (A), nearly normal (B), abnormal (C), and severely abnormal (D), with the final IKDC rating based on the score of the worst category.
Time frame: 15 years
Population: Loss to follow-up or questionnaire-only subject
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | B | 19 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | D | 0 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | B | 27 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | A | 6 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | A | 17 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | A | 8 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | D | 0 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | B | 12 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | A | 21 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | C | 7 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | C | 4 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | A | 0 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | B | 16 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | D | 0 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | B | 16 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | A | 9 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | C | 3 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | C | 2 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | C | 17 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | D | 0 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | D | 1 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | A | 21 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | B | 6 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | D | 0 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | B | 11 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | D | 1 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | C | 1 Participants |
| Low-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | C | 5 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | A | 5 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | A | 0 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | B | 28 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | C | 13 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | D | 2 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | A | 21 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | B | 15 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | C | 1 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 6-months | D | 0 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | A | 16 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | B | 16 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | D | 0 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | A | 17 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | B | 11 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | C | 5 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | D | 0 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | A | 7 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | B | 22 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | C | 0 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | D | 0 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | A | 8 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | B | 9 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | C | 3 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | D | 2 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | C | 5 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | B | 6 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | C | 2 Participants |
| High-tension | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | D | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | D | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | A | 58 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | A | 22 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | C | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | B | 5 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | B | 4 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | B | 2 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | B | 2 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | C | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 1-year | A | 46 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | D | 1 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 10-12-years | D | 1 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | D | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | D | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | A | 24 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | C | 2 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | C | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | B | 8 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | B | 5 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 15-years | A | 14 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | C | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 3-years | A | 30 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | Baseline | C | 0 Participants |
| Uninjured Control Group | Limb Strength International Knee Documentation Committee (IKDC) Score | 7-years | D | 0 Participants |
Comparison: These results are from the 15-year analysis.p-value: 0.34Chi-squared
Secondary
Modified OsteoArthritis Research Society International (OARSI) Score
OARSI-The overall condition of the knee joints of both surgical and contralateral limbs were graded on radiographs by a radiologist. (0-83). 83-severe damage.0- no damage. The difference of the score between surgical and contralateral limbs is also presented.
Time frame: 15 years
Population: Insufficient time for imaging; loss to follow-up
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Modified OsteoArthritis Research Society International (OARSI) Score | Baseline | -0.0541 score on a scale |
| Low-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 1-year | 0 score on a scale |
| Low-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 3-year | 0.7679 score on a scale |
| Low-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 7-year | 1.0667 score on a scale |
| Low-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 10-12-year | 2.2222 score on a scale |
| Low-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 15-year | 2.2813 score on a scale |
| High-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 15-year | 0.5833 score on a scale |
| High-tension | Modified OsteoArthritis Research Society International (OARSI) Score | Baseline | -0.1081 score on a scale |
| High-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 7-year | 0.6724 score on a scale |
| High-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 10-12-year | 0.7857 score on a scale |
| High-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 1-year | 0.3400 score on a scale |
| High-tension | Modified OsteoArthritis Research Society International (OARSI) Score | 3-year | 0.5000 score on a scale |
| Uninjured Control Group | Modified OsteoArthritis Research Society International (OARSI) Score | 1-year | -0.3125 score on a scale |
| Uninjured Control Group | Modified OsteoArthritis Research Society International (OARSI) Score | 3-year | -0.0185 score on a scale |
| Uninjured Control Group | Modified OsteoArthritis Research Society International (OARSI) Score | 15-year | 0.0278 score on a scale |
| Uninjured Control Group | Modified OsteoArthritis Research Society International (OARSI) Score | 7-year | -0.1667 score on a scale |
| Uninjured Control Group | Modified OsteoArthritis Research Society International (OARSI) Score | Baseline | -0.2604 score on a scale |
| Uninjured Control Group | Modified OsteoArthritis Research Society International (OARSI) Score | 10-12-year | -0.0385 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.067ANOVA
Secondary
Muscle Atrophy
Thigh circumference 6 cm above the joint line for injured and contralateral knees. Muscle atrophy difference calculated as index-contralateral circumference.
Time frame: 15 years
Population: Participant population declined due to loss to follow-up or insufficient time to test at the appointment. Control subjects were not tested at the 6-month follow-up.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Muscle Atrophy | 1-year | 0.6579 centimeters |
| Low-tension | Muscle Atrophy | 10-12-years | -0.3600 centimeters |
| Low-tension | Muscle Atrophy | Baseline | -0.0267 centimeters |
| Low-tension | Muscle Atrophy | 6-months | 0.9324 centimeters |
| Low-tension | Muscle Atrophy | 3-years | -0.3359 centimeters |
| Low-tension | Muscle Atrophy | 7-years | -0.2625 centimeters |
| Low-tension | Muscle Atrophy | 15-years | -0.2941 centimeters |
| High-tension | Muscle Atrophy | 6-months | 0.7071 centimeters |
| High-tension | Muscle Atrophy | 1-year | 0.7896 centimeters |
| High-tension | Muscle Atrophy | 3-years | -0.3030 centimeters |
| High-tension | Muscle Atrophy | 15-years | -0.7308 centimeters |
| High-tension | Muscle Atrophy | 7-years | -0.4783 centimeters |
| High-tension | Muscle Atrophy | 10-12-years | -0.4318 centimeters |
| High-tension | Muscle Atrophy | Baseline | -0.2093 centimeters |
| Uninjured Control Group | Muscle Atrophy | 10-12-years | 0.1000 centimeters |
| Uninjured Control Group | Muscle Atrophy | 1-year | 0.3520 centimeters |
| Uninjured Control Group | Muscle Atrophy | 15-years | 0 centimeters |
| Uninjured Control Group | Muscle Atrophy | Baseline | 0.0293 centimeters |
| Uninjured Control Group | Muscle Atrophy | 3-years | 0.2105 centimeters |
| Uninjured Control Group | Muscle Atrophy | 7-years | 0.0323 centimeters |
Secondary
One-legged Hop Test
Ratio of hop distance on the injured knee to the hop distance on the contralateral uninjured knee.
Time frame: 15 years
Population: Some surgical subjects declined to perform due to knee instability. Other subjects had insufficient time to test. There was loss to follow-up at later timepoints.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | One-legged Hop Test | 3-years | 94.3962 percentage of contralateral knee |
| Low-tension | One-legged Hop Test | Baseline | 76.8510 percentage of contralateral knee |
| Low-tension | One-legged Hop Test | 1-year | 91.2106 percentage of contralateral knee |
| Low-tension | One-legged Hop Test | 7-years | 93.0311 percentage of contralateral knee |
| Low-tension | One-legged Hop Test | 10-12-years | 94.9735 percentage of contralateral knee |
| Low-tension | One-legged Hop Test | 15-years | 93.2949 percentage of contralateral knee |
| High-tension | One-legged Hop Test | 1-year | 93.0460 percentage of contralateral knee |
| High-tension | One-legged Hop Test | 3-years | 95.2889 percentage of contralateral knee |
| High-tension | One-legged Hop Test | 7-years | 94.8787 percentage of contralateral knee |
| High-tension | One-legged Hop Test | 15-years | 85.1336 percentage of contralateral knee |
| High-tension | One-legged Hop Test | 10-12-years | 92.2336 percentage of contralateral knee |
| High-tension | One-legged Hop Test | Baseline | 76.9565 percentage of contralateral knee |
| Uninjured Control Group | One-legged Hop Test | Baseline | 101.0724 percentage of contralateral knee |
| Uninjured Control Group | One-legged Hop Test | 10-12-years | 100.0648 percentage of contralateral knee |
| Uninjured Control Group | One-legged Hop Test | 3-years | 100.7867 percentage of contralateral knee |
| Uninjured Control Group | One-legged Hop Test | 15-years | 101.0900 percentage of contralateral knee |
| Uninjured Control Group | One-legged Hop Test | 1-year | 100.6628 percentage of contralateral knee |
| Uninjured Control Group | One-legged Hop Test | 7-years | 101.3066 percentage of contralateral knee |
Comparison: These results were from the 15-year analysis.p-value: 0.14ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Bodily Pain
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the bodily pain score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 1-year | 82.4167 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 3-years | 84.6216 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | Baseline | 62.3778 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 6 months | 80.2727 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 7-years | 79.2778 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 15-years | 78.4231 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 10-12-years | 83.1613 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 6 months | 77.5571 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 10-12-years | 88.1786 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 15-years | 89.1743 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 1-year | 85.1750 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | Baseline | 61.0000 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 3-years | 86.8824 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Bodily Pain | 7-years | 86.8611 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Bodily Pain | 15-years | 81.6667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Bodily Pain | Baseline | 86.6500 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Bodily Pain | 1-year | 87.0000 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Bodily Pain | 3-years | 84.7895 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Bodily Pain | 7-years | 86.0000 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Bodily Pain | 10-12-years | 82.4857 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.15ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Emotional Role
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the emotional role score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 1-year | 92.1278 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 3-years | 94.1441 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | Baseline | 85.3704 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 6 months | 89.3930 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 7-years | 95.1289 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 15-years | 91.0256 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 10-12-years | 97.3123 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 6 months | 91.9188 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 10-12-years | 97.3218 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 15-years | 96.8254 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 1-year | 92.771 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | Baseline | 85.3175 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 3-years | 97.5500 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Emotional Role | 7-years | 95.6019 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Emotional Role | 15-years | 97.5000 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Emotional Role | Baseline | 96.6667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Emotional Role | 1-year | 98.2277 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Emotional Role | 3-years | 96.3667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Emotional Role | 7-years | 97.0588 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Emotional Role | 10-12-years | 97.8571 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.03ANOVA
Secondary
Short Form-36 (SF-36) Health Survey General Health
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the general health score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | 1-year | 84.9722 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | 3-years | 82.4865 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | Baseline | 81.9111 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | 6 months | 83.4412 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | 7-years | 80.1111 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | 15-years | 80.8462 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey General Health | 10-12-years | 81.9355 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | 6 months | 82.2286 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | 10-12-years | 82.3214 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | 15-years | 84.7143 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | 1-year | 85.6750 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | Baseline | 84.9767 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | 3-years | 85.2941 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey General Health | 7-years | 84.8611 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey General Health | 15-years | 82.4655 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey General Health | Baseline | 86.1667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey General Health | 1-year | 86.6170 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey General Health | 3-years | 85.1795 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey General Health | 7-years | 86.6765 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey General Health | 10-12-years | 84.2000 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.61ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Mental Health
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the mental health score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | 1-year | 78.4722 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | 3-years | 82.2973 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | Baseline | 74.1111 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | 6 months | 80.0000 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | 7-years | 79.8611 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | 15-years | 78.4135 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Mental Health | 10-12-years | 80.9677 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | 6 months | 83.5714 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | 10-12-years | 81.9643 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | 15-years | 81.9048 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | 1-year | 82.6250 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | Baseline | 74.8837 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | 3-years | 86.0294 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Mental Health | 7-years | 85.0000 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Mental Health | 15-years | 80.6667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Mental Health | Baseline | 84.1667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Mental Health | 1-year | 82.4468 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Mental Health | 3-years | 85.5128 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Mental Health | 7-years | 84.8529 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Mental Health | 10-12-years | 80.7143 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.67ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Physical Functioning
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the physical functioning score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 1-year | 89.1667 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 3-years | 89.9865 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | Baseline | 70.0000 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 6 months | 83.8971 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 7-years | 91.9444 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 15-years | 91.1538 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 10-12-years | 90.0000 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 6 months | 83.1429 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 10-12-years | 95.1786 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 15-years | 91.9048 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 1-year | 90.7500 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | Baseline | 70.1163 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 3-years | 93.9706 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Functioning | 7-years | 95.1389 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Functioning | 15-years | 97.1667 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Functioning | Baseline | 98.3333 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Functioning | 1-year | 99.0426 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Functioning | 3-years | 95.8974 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Functioning | 7-years | 97.6471 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Functioning | 10-12-years | 96.4286 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.17ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Physical Role
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the physical role score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | 1-year | 91.8403 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | 3-years | 91.7230 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | Baseline | 59.5833 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | 6 months | 86.3971 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | 7-years | 94.2708 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | 15-years | 90.1442 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Physical Role | 10-12-years | 96.5276 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | 6 months | 82.5840 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | 10-12-years | 96.2054 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | 15-years | 96.1310 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | 1-year | 92.0313 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | Baseline | 54.0698 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | 3-years | 96.6912 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Physical Role | 7-years | 97.5694 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Role | 15-years | 95.2083 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Role | Baseline | 97.6389 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Role | 1-year | 96.4096 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Role | 3-years | 95.6731 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Role | 7-years | 96.5074 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Physical Role | 10-12-years | 95.7143 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.25ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Social Function
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the social function score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | 1-year | 92.7083 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | 3-years | 94.5946 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | Baseline | 81.1111 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | 6 months | 88.6364 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | 7-years | 89.9306 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | 15-years | 90.3846 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Social Function | 10-12-years | 95.9677 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | 6 months | 90.0000 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | 10-12-years | 96.4286 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | 15-years | 92.8571 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | 1-year | 92.6563 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | Baseline | 75.5814 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | 3-years | 97.4265 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Social Function | 7-years | 96.5278 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Social Function | 15-years | 90.0000 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Social Function | Baseline | 96.4583 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Social Function | 1-year | 97.2826 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Social Function | 3-years | 96.7949 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Social Function | 7-years | 97.0588 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Social Function | 10-12-years | 93.9286 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.82ANOVA
Secondary
Short Form-36 (SF-36) Health Survey Vitality
The SF-36 evaluates general health related to physical function, role limitations, bodily pain, vitality, social functioning, mental health, and health transition. Each sub score is on a 0-100 scale. 100 indicates no problems and 0 indicates severe problems.
Time frame: 15 years
Population: Some subjects omitted responses from questions pertaining to the vitality score. These subjects were omitted from the overall N for score calculations.~Loss to follow-up between time-points accounts for the remaining population differences. Control subjects were not assessed at 6 months.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | 1-year | 69.7917 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | 3-years | 69.2568 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | Baseline | 62.6733 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | 6 months | 65.3409 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | 7-years | 68.4028 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | 15-years | 64.9038 score on a scale |
| Low-tension | Short Form-36 (SF-36) Health Survey Vitality | 10-12-years | 67.4058 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | 6 months | 73.3929 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | 10-12-years | 72.3214 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | 15-years | 70.5357 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | 1-year | 71.4063 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | Baseline | 64.0988 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | 3-years | 73.1618 score on a scale |
| High-tension | Short Form-36 (SF-36) Health Survey Vitality | 7-years | 72.9456 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Vitality | 15-years | 67.9167 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Vitality | Baseline | 73.2292 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Vitality | 1-year | 70.3457 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Vitality | 3-years | 73.5577 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Vitality | 7-years | 70.9559 score on a scale |
| Uninjured Control Group | Short Form-36 (SF-36) Health Survey Vitality | 10-12-years | 70.0000 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.53ANOVA
Secondary
Tegner Activity Scale
The Tegner activity scale graded activity level based on work and sports activity on a scale of 1-10 with 1 representing physical disability due to knee problems and 10 indicating national or international level soccer participation.
Time frame: 15-years
Population: Subjects were lost to follow-up throughout the study.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Tegner Activity Scale | 1-year | 6.1282 score on a scale |
| Low-tension | Tegner Activity Scale | Baseline | 7.6087 score on a scale |
| Low-tension | Tegner Activity Scale | 3-years | 5.5556 score on a scale |
| Low-tension | Tegner Activity Scale | 7-years | 4.8056 score on a scale |
| Low-tension | Tegner Activity Scale | 10-12-years | 4.6452 score on a scale |
| Low-tension | Tegner Activity Scale | 15-years | 4.1538 score on a scale |
| High-tension | Tegner Activity Scale | 15-years | 4.8571 score on a scale |
| High-tension | Tegner Activity Scale | 1-year | 6.6000 score on a scale |
| High-tension | Tegner Activity Scale | 10-12-years | 5.2143 score on a scale |
| High-tension | Tegner Activity Scale | Baseline | 7.6363 score on a scale |
| High-tension | Tegner Activity Scale | 7-years | 5.6111 score on a scale |
| High-tension | Tegner Activity Scale | 3-years | 6.0286 score on a scale |
| Uninjured Control Group | Tegner Activity Scale | 1-year | 6.3111 score on a scale |
| Uninjured Control Group | Tegner Activity Scale | 3-years | 5.6154 score on a scale |
| Uninjured Control Group | Tegner Activity Scale | 15-years | 5.0333 score on a scale |
| Uninjured Control Group | Tegner Activity Scale | 7-years | 5.4412 score on a scale |
| Uninjured Control Group | Tegner Activity Scale | Baseline | 6.5333 score on a scale |
| Uninjured Control Group | Tegner Activity Scale | 10-12-years | 5.1143 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.08ANOVA
Secondary
Whole Organ Magnetic Resonance Image Score (WORMS)
The OA status of the knee was assessed using the semiquantitative Whole Organ Magnetic Resonance Imaging Score (WORMS).The score uses magnetic resonance imaging (MRI) sequences to grade 14 independent features: cartilage signal and morphological characteristics, subarticular bone marrow abnormality, subarticular cysts, subarticular bone attrition, and marginal osteophytes evaluated in 15 regions. The condition of the menisci, cruciate and collateral ligaments, synovitis, loose bodies, and periarticular cysts was also included for a total possible score of 332 points. 0-indicates no damage in anatomical landmarks assessed. 332-severe damage to the anatomical landmarks assessed.
Time frame: 15 years
Population: Insufficient time for imaging; loss to follow-up.
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Low-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | Baseline | 3.7941 score on a scale |
| Low-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 1-year | 3.5278 score on a scale |
| Low-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 3-year | 3.1852 score on a scale |
| Low-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 7-year | 8.1667 score on a scale |
| Low-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 10-12-year | 11.6731 score on a scale |
| Low-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 15-year | 11.2333 score on a scale |
| High-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 15-year | 10.0000 score on a scale |
| High-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | Baseline | 6.1875 score on a scale |
| High-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 7-year | 2.8929 score on a scale |
| High-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 10-12-year | 7.3095 score on a scale |
| High-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 1-year | 6.9286 score on a scale |
| High-tension | Whole Organ Magnetic Resonance Image Score (WORMS) | 3-year | 3.2917 score on a scale |
| Uninjured Control Group | Whole Organ Magnetic Resonance Image Score (WORMS) | 1-year | -0.9583 score on a scale |
| Uninjured Control Group | Whole Organ Magnetic Resonance Image Score (WORMS) | 3-year | -0.3333 score on a scale |
| Uninjured Control Group | Whole Organ Magnetic Resonance Image Score (WORMS) | 15-year | -1.2500 score on a scale |
| Uninjured Control Group | Whole Organ Magnetic Resonance Image Score (WORMS) | 7-year | -1.3548 score on a scale |
| Uninjured Control Group | Whole Organ Magnetic Resonance Image Score (WORMS) | Baseline | 0.9167 score on a scale |
| Uninjured Control Group | Whole Organ Magnetic Resonance Image Score (WORMS) | 10-12-year | -3.8400 score on a scale |
Comparison: These results are from the 15-year analysis.p-value: 0.051ANOVA