Osteoarthritis More Likely Following ACL Reconstruction

Osteoarthritis was approximately three times more likely to occur in the knee of a patient who underwent anterior cruciate ligament (ACL) reconstruction compared with the contralateral knee, according to a recent study.

Researchers conducted a regression analysis in 135 patients following ACL reconstruction. Patients were randomized to receive a semitendinosus tendon or bone-patellar tendon-bone graft at a mean of 14 years postoperatively. At this time, factors such as radiologic results, Tegner activity levels, and KOOS values were analyzed.

Medial compartment osteoarthritis (OA) was observed in 57 percent of OA cases in the reconstructed knee and 18 percent of cases in the contralateral knee. Lower KOOS results were seen in patients with OA in all subscales, showing a likelihood that OA was symptomatic, according to the researchers.

Time between injury and reconstruction was not found to be a significant risk factor. Additionally, no significant difference in OA or KOOS values was observed between graft types. Meniscus resection was a strong risk factor for medial compartment OA, according to the researchers.

More than 200,000 ACL injuries occur annually, with 100,000 of those cases requiring knee reconstruction, according to industry data. The majority of ACL injuries — 70 percent — occur while playing agility sports such as basketball, soccer, skiing, and football. An estimated 70 percent of ACL injuries are sustained through non-contact mechanisms, while the remaining 30 percent result from direct contact, data show.

ACL injuries range from a partial tear to a complete tear to bone avulsions. Partial and complete ACL tears are repaired with sutures or reconstructed using a graft. Bone avulsions are repaired by reattaching the bony fragment.

Approximately 50 percent of ACL injuries occur with injuries to other structures in the knee. The meniscus (50 percent of multi-structure injuries), medial collateral ligament (30 percent), or articular cartilage (30 percent) are the most frequently concurrently injured structures. The lateral meniscus is more often damaged than the medial meniscus during an isolated acute ACL injury, statistics indicate.