Research advances on the development of osteoarthritis after anterior cruciate ligament reconstruction

Abstract

Anterior cruciate ligament is the most important ligament to maintain the anterior and rotation stability of knee joint. Rupture of anterior cruciate ligament is one of the most common injuries of knee joint, and thus leads to knee instability and traumatic osteoarthritis. Anterior cruciate ligament reconstruction is usually performed to restore the anterior stability of knee joint, and is considered to reduce the secondary injury of medial meniscus, lateral meniscus and cartilage. Thus anterior cruciate ligament reconstruction can improve the function of knee joint. Traditional single bundle technique to reconstruct anterior cruciate ligament has been performed for many years. This technique can restore the anterior stability of knee joint and has excellent clinical results. Nearly 61% patients showed obvious radiographic osteoarthritis 20 years after anterior cruciate ligament reconstruction using bone-patella-bone graft. But, there is no agreement regarding to reduce the development of osteoarthritis after reconstruction of anterior cruciate ligament. However, it has been reported that osteoarthritis would develop after reconstruction of anterior cruciate ligament in long term follow up study. Recently, with the further understanding of anatomy of biomechanics of anterior cruciate ligament, new techniques for anterior cruciate ligament reconstruction are developed, such as double bundle reconstruction, anatomic reconstruction and individual reconstruction. It remains controversial that whether these new technique can prevent the development of osteoarthritis after rupture of anterior cruciate ligament. Currently, no reconstruction technique for anterior cruciate ligament is perfect, and every technique has advantages and disadvantages. In terms of reducing the prevalence of osteoarthritis after reconstruction of anterior cruciate ligament, which technique is the best still remains unclear. New treatment and evaluation methods should be developed. In the future, not only the restoration of stability of knee joint should be considered, but also the articular cartilage contact kinematics including tibiofemoral joint and patellofemoral joint after anterior cruciate ligament recon-struction. Reduction of the development of osteoarthritis is an important topic after reconstruction of anterior cruciate ligament.