Effects of arthroscopic anterior cruciate ligament reconstruction combined with sodium hyaluronate on knee function and inflammatory markers in anterior cruciate ligament injury patients with or without knee osteoarthritis.

Abstract

Anterior cruciate ligament injury (ACLI) is a common sports injury of the knee joint, and ACLI patients often develop early knee osteoarthritis (KOA) after surgery. This may be due to the activation of a post-surgical inflammatory response. To investigate the treatment efficacy of arthroscopic anterior cruciate ligament reconstruction (AACLR) combined with sodium hyaluronate (SH) in ACLI patients with and without KOA. This prospective cohort study included 226 ACLI patients with or without KOA who were admitted between July 2015 and December 2018 into The Second Xiangya Hospital, Changsha, China. All patients received AACLR surgery combined with 50 mg SH. Serum levels of inflammatory markers were evaluated with enzyme-linked immunosorbent assay (ELISA), and knees were assessed using the Lysholm Knee Score and the International Knee Documentation Committee Knee Evaluation Form (IKDC). The range of motion of the knee joint was also measured. The mean disease course was 73.39 ±30.90 months for ACLI patients with KOA, which was significantly longer than for those without KOA (3.74 ±1.70 months). Also, surgery duration was remarkably longer for patients with KOA than it was for those without this disease. The Lysholm Knee Score and IKDC score, as well as the range of knee joint motion were significantly improved in all patients after treatment compared to baseline. However, no significant differences were found between the groups. One day, 3 days and 7 days after surgery, significantly higher inflammatory marker levels were found in the patients with KOA than in those without KOA. The AACLR combined with SH was efficacious as it improved knee function and inflammation in all patients, while patients without KOA exhibited a more rapid recovery from the post-surgical inflammatory response.