Knee Osteoarthritis Following Anterior Cruciate Ligament Reconstruction: Frequency, Contributory Elements, and Recent Interventions to Modify the Route of Degeneration.

Abstract

Half of the individuals who experience an anterior cruciate ligament reconstruction (ACLR) suffer from knee osteoarthritis (OA) 12-14 years later. Elements that make a contribution to the appearance of OA following ACLR are anomalous anterior tibial displacement and anomalous tibial rotation in the course of the stance phase of walking (exhibited in 85% of operated knees). Individuals who undergo an early ACLR (5 days on average following anterior cruciate ligament [ACL] breakage) have an inferior frequency of radiographically apparent tibiofemoral OA at 32-37 years of follow-up than individuals with ACL rupture who did not experience the procedure. Nevertheless, the percentage of symptomatic OA, radiographically apparent patellofemoral OA and knee symptoms are alike in both groups. At 15 years of follow-up, 23% of knees that experienced an anatomic ACLR suffer from OA, while this percentage augments to 44% if the ACLR was non-anatomic. Knees of individuals who experience ACLR need total knee arthroplasty at an earlier age than healthy knees. Intra-articular injections of interleukin-1 receptor antagonist and corticosteroids may reduce the risk of OA after ACLR.