Abstract
ObjectiveThis study aimed to support the potential protective role of anterior cruciate ligament (ACL) reconstruction against the development of osteoarthritis (OA).MethodsIn this retrospective cohort study, the long-term results of ACL reconstruction in Taiwan were evaluated based on data from the National Health Insurance Research Database (NHIRD). In total, 8,769 eligible cases were included from 11,921 ACL-injured patients. The cumulative incidence rates of OA and total knee replacement (TKR) were analyzed using the Kaplan-Meier estimator. Cox proportional hazards models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of OA.ResultsThere was a lower cumulative incidence of OA among ACL-reconstructed patients (271, 33.1%) than among non-reconstructed patients (1,874, 40.3%; p < 0.001). Patients who underwent ACL reconstruction had a lower cumulative incidence of TKR during the follow-up period (0.6%) than the non-reconstructed patients (4.6%, p < 0.001). After adjusting for covariates, ACL-injured patients who underwent reconstruction within one month after ACL injury showed a significantly lower risk of OA than those who never underwent reconstruction (adjusted HR = 0.83, 95% CI = 0.69–0.99).ConclusionsThese results indicate that ACL reconstruction might not provide complete protection from OA development after traumatic knee injury but does yield a lower cumulative incidence of OA development and TKR. Moreover, based on the present study, ACL-injured patients should undergo reconstruction as early as possible (within one month) to lower the risk of OA.
Highlights
Epidemiological studies have found that a history of knee injury is associated with an increased risk of osteoarthritis (OA) [1]
After adjusting for covariates, anterior cruciate ligament (ACL)-injured patients who underwent reconstruction within one month after ACL injury showed a significantly lower risk of OA than those who never underwent reconstruction
These results indicate that ACL reconstruction might not provide complete protection from OA development after traumatic knee injury but does yield a lower cumulative incidence of OA development and total knee replacement (TKR)
Summary
Epidemiological studies have found that a history of knee injury is associated with an increased risk of osteoarthritis (OA) [1]. A long-term follow-up study reported that people with a knee injury had at least a 5-fold increased risk of developing knee OA [2]. One of the most common knee injuries is anterior cruciate ligament (ACL) injury, for which reconstruction is frequently performed [3,4,5]. Previous studies have reported an annual incidence of ACL injury in the general population of 0.8 per 1,000 [6]. More than 100,000 new cases of ACL injury occur, and approximately 75,000 ACL reconstructions are performed in the United States [7]. Knee OA often develops after ACL injury [8].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
