Posttraumatisch botoedeem drie maanden na operatieve en conservatieve behandeling van een voorste kruisbandletsel en de correlatie met pijn: een exploratieve analyse van de IODA piloot studi

Abstract

Posttraumatic bone edema three months after anterior cruciate ligament injury and correlation with pain, a comparison between operatively and conservatively treated patients: an exploratory analysis of the IODA pilot trial Background/Purpose: Recent years have seen a surge of research comparing conservative treatment with immediate surgery for anterior cruciate ligament (ACL) injuries, with some studies reporting comparable clinical outcomes between both approaches. In this study, we aim to compare magnetic resonance imaging (MRI) findings in both treatment groups, in particular bone edema. Methods: This randomized controlled trial involved 25 patients with an acute ACL injury who were assigned to 1) immediate ACL reconstruction or 2) conservative treatment with optional delayed surgery. (1) Two MRI scans were conducted, at the time of injury and after three months, and scored using the Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS). Pain was assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). A multivariate linear regression analysis was performed to evaluate the impact of both treatments on bone edema evolution; while a bivariate correlation analysis was conducted to examine the possible relationship between bone edema and pain. Results: Type of treatment had a significant influence on the amount of bone edema after three months, after correcting for bone edema at diagnosis, with higher scores in the operative group. No significant correlation was observed between bone edema and pain at the time of injury (r=0,183, p=0,403) or after three months (r=0,161, p=0,499). Conclusion: Our findings suggest that ACL reconstruction may have an adverse effect on the amount of bone edema at three months, although no significant correlation was seen between bone edema and pain. Further analysis with larger sample size are planned (IODA trial).