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



Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain


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 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 peril of OA after ACLR.
Level of evidence: III