1 3 Knee Surg Sports Traumatol Arthrosc DOI 10.1007/s00167-015-3593-9 KNEE No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years Dimitrios Tsoukas 1 · Vasilios Fotopoulos 2 · Georgios Basdekis 3 · Konstantinos G. Makridis 4,5 Received: 8 October 2013 / Accepted: 30 March 2015 © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015 33 years, range 25–39). Seventeen patients were operated (median age 31 years, range 20–36). There was signifi- cant difference between the mean values of IKDC scores in favour of the ACL-reconstruction group of patients, 86.8 (SD 6.5) versus 77.5 (SD 13.8), respectively (p = 0.04). The mean value of anteroposterior tibial translation was 1.5 mm (SD 0.2) for ACL-reconstruction group of patients, while the corresponding mean value for ACL-conserva- tive group was 4.5 mm (SD 0.5), p = 0.03. Four patients in ACL-reconstruction group had radiological findings of grade C or D according to IKDC form. In ACL-conserva- tive group, five patients presented similar signs (n.s.). Conclusions ACL reconstruction using hamstrings auto- graft resulted in better functional outcome and laxity meas- urements than ACL-conservative management. However, the incidence of radiological osteoarthritis was similar between the two groups and independent on the pre-oper- ative grade of laxity and functional status of the patients. Equally, bone bruises were not found as a risk factor for the development of osteoarthritis after ACL rupture. Level of evidence Prospective randomized study, Level II. Keywords ACL reconstruction · ACL-conservative treatment · Prospective study · Osteoarthritis · Hamstring autograft Introduction Anterior cruciate ligament (ACL) is an important ligament for proper knee function, and a rupture of this structure can be a debilitating musculoskeletal injury, especially for the young athletes. Treatment depends on the previous activ- ity level, characteristics of the injury and degree of the instability. Low-demand patients with partial tears and no Abstract Purpose Aim of this study was to record and compare the functional and activity level as well as the manifestations of osteoarthritis after isolated ACL ruptures between patients with conservative treatment and ACL reconstruction with hamstrings tendon graft. Methods Thirty-two patients diagnosed with ACL rupture were recorded. Clinical examination included the Tegner and Lysholm activity scale, the International Knee Documenta- tion Committee Subjective Form and KT-1000 arthrom- eter. Narrowing of the medial and lateral joint spaces was assessed using the IKDC knee examination score. Results Median follow-up was 10.3 years (range 10–11). Fifteen patients were conservatively treated (median age * Konstantinos G. Makridis kmakrid@yahoo.gr Dimitrios Tsoukas info@tsoukas-ortho.gr Vasilios Fotopoulos fotova@yahoo.gr Georgios Basdekis geobasd@yahoo.gr 1 Orthopaedic Sports Medicine Clinic, 1-3 Distomou Street, Maroussi, 15125 Athens, Greece 2 Royal Sussex County Hospital, Eastern Road, Brighton, East Sussex BN2 5BE, UK 3 Academic Department of Orthopaedic Surgery and Musculoskeletal Trauma, Faculty of Medicine, University of Thessaly, Larissa, Greece 4 Flat 155F, Block D, The Plaza, Claypit Lane, Leeds LS2 8BN, UK 5 Centre Nollet (Teaching center – approved by ESSKA), Leeds Teaching Hospitals NHS Trust, Leeds, UK