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This Article Full Text (PDF) Free All Versions of this Article: 35/3/493    most recent 0363546506298111v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bollen, S. Articles by Salmon, L. Search for Related Content PubMed PubMed Citation Articles by Bollen, S. Articles by Salmon, L.

Letters to the Editor

North Rigton, United Kingdom

Dear Editor,

I write with regard to "Long-term Outcome of Endoscopic Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft: Minimum 13-Year Review" by Salmon et al (May 2006, pp 721–732). I feel some of the emphasis stated in the abstract and conclusion is a little disingenuous, specifically the statement "Radiographic degenerative changes were seen in three quarters of patients." The authors’ gradings of A (no degenerative change) and B (minimal changes or barely detectable joint-space narrowing) were seen in 79% of patients at 13 years, so an equally valid statement in the abstract could read "79% of patients had no or minimal radiographic changes on their radiographs at 13 years," which changes the perception of the outcome considerably. This also needs to be put in context with the postoperative regimen with restriction of flexion, bracing, and restricted weight bearing—a practice that is no longer used.

Author’s Response

North Sydney Orthopaedic and Sports Medicine Centre, Sydney, Australia

I thank Dr. Bollen for his comments regarding this article. The breakdown of mild to severe grading was clearly reported in the Results section. The authors feel that the inclusion of patients with minimal radiographic degenerative changes is significant in this subgroup of patients of mean age 40 years. By comparison, Petersson et al¹ reported that the incidence of minimal or greater radiographic change in a population aged 35 to 54 years with chronic knee pain was around 1%.

With respect to Dr. Bollen’s comments regarding outdated techniques, I agree that more modern techniques and rehabilitation are likely to obtain more favorable results, as is discussed in the article on page 731.

REFERENCE

1. Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahleback and Kellgren and Lawrence systems for the tibiofemoral joint in people aged between 35–54 years with chronic knee pain. Ann Rheum Dis. 1997;56:493–496.[Abstract/Free Full Text]

This Article Full Text (PDF) Free All Versions of this Article: 35/3/493    most recent 0363546506298111v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bollen, S. Articles by Salmon, L. Search for Related Content PubMed PubMed Citation Articles by Bollen, S. Articles by Salmon, L.