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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2020

01-03-2020 | Osteoarthrosis | KNEE

Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstruction

Authors: Stephan G. Bodkin, Brian C. Werner, Lindsay V. Slater, Joseph M. Hart

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2020

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Abstract

Purpose

The purpose was to calculate the incidence of osteoarthritis in individuals following Anterior Cruciate Ligament Reconstruction (ACLR) in a large, national database and to examine the risk factors associated with OA development.

Methods

A commercially available insurance database was queried to identify new diagnoses of knee OA in patients with ACLR. The cumulative incidence of knee OA diagnoses in patients after ACLR was calculated and stratified by time from reconstruction. Odds ratios were calculated using logistic regression to describe factors associated with a new OA diagnosis including age, sex, BMI, meniscus involvement, osteochondral graft use, and tobacco use.

Results

A total of 10,565 patients with ACLR were identified that did not have an existing diagnosis of OA, 517 of which had a documented new diagnosis of knee OA 5 years after ACL reconstruction. When stratified by follow-up time points, the incidence of a new OA diagnosis within 6 months was 2.3%; within a 1-year follow-up was 4.1%; within 2 years, follow-up was 6.2%, within 3 years, follow-up was 8.4%; within 4 years, follow-up was 10.4%; and within 5 years, follow-up was 12.3%. Risk factors for new OA diagnoses were age (OR 2.44, P < 0.001), sex (OR 1.2, P = 0.002), obesity (OR 1.4, P < 0.001), tobacco use (OR = 1.3, P = 0.001), and meniscal involvement (OR 1.2, P = 0.005).

Conclusion

Approximately 12% of patients presenting within 5 years following ACLR are diagnosed with OA. Demographic factors associated with an increased risk of a diagnosis of PTOA within 5 years after ACLR are age, sex, BMI, tobacco use, and concomitant meniscal surgery. Clinicians should be cognizant of these risk factors to develop risk profiles in patients with the common goal to achieve optimal long-term outcomes after ACLR.

Level of evidence

III.
Literature
1.
Anderson DD, Chubinskaya S, Guilak F, Martin JA, Oegema TR, Olson SA et al (2011) Post-traumatic osteoarthritis: improved understanding and opportunities for early intervention. J Orthop Res 29:802–809PubMedPubMedCentral
2.
Ardern CL, Webster KE, Taylor NF, Feller JA (2011) Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 45:596–606PubMed
3.
Barenius B, Ponzer S, Shalabi A, Bujak R, Norlen L, Eriksson K (2014) Increased risk of osteoarthritis after anterior cruciate ligament reconstruction: a 14-year follow-up study of a randomized controlled trial. Am J Sports Med 42:1049–1057PubMed
4.
Berenbaum F, Eymard F, Houard X (2013) Osteoarthritis, inflammation and obesity. Curr Opin Rheumatol 25:114–118PubMed
5.
Blagojevic M, Jinks C, Jeffery A, Jordan KP (2010) Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthr Cartil 18:24–33
6.
Blyth MJG, Gosal HS, Peake WM, Bartlett RJ (2003) Anterior cruciate ligament reconstruction in patients over the age of 50 years: 2- to 8-year follow-up. Knee Surg Sports Traumatol Arthrosc 11:204–211PubMed
7.
Brown TD, Johnston RC, Saltzman CL, Marsh JL, Buckwalter JA (2006) Posttraumatic osteoarthritis: a first estimate of incidence, prevalence, and burden of disease. J Orthop Trauma 20:739–744PubMed
8.
Chockalingam PS, Glasson SS, Lohmander LS (2013) Tenascin-C levels in synovial fluid are elevated after injury to the human and canine joint and correlate with markers of inflammation and matrix degradation. Osteoarthr Cartil 21:339–345
9.
Cinque ME, Dornan GJ, Chahla J, Moatshe G, LaPrade RF (2017) High rates of osteoarthritis develop after anterior cruciate ligament surgery: an analysis of 4108 patients. Am J Sports Med 46(8):2011– 2019PubMed
10.
Collins JE, Katz JN, Donnell-Fink LA, Martin SD, Losina E (2013) Cumulative incidence of ACL reconstruction after ACL injury in adults role of age, sex, and race. Am J Sports Med 41:544–549PubMedPubMedCentral
11.
Cooper C, Inskip H, Croft P, Campbell L, Smith G, McLaren M et al (1998) Individual risk factors for hip osteoarthritis: obesity, hip injury and physical activity. Am J Epidemiol 147:516–522PubMed
12.
Cox CL, Huston LJ, Dunn WR, Reinke EK, Nwosu SK, Parker RD et al (2014) Are articular cartilage lesions and meniscus tears predictive of IKDC, KOOS, and Marx activity level outcomes after anterior cruciate ligament reconstruction? A 6-year multicenter cohort study. Am J Sports Med 42:1058–1067PubMedPubMedCentral
13.
Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M et al (2014) The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73:1323–1330PubMed
14.
Dekker TJ, Godin JA, Dale KM, Garrett WE, Taylor DC, Riboh JC (2017) Return to sport after pediatric anterior cruciate ligament reconstruction and its effect on subsequent anterior cruciate ligament injury. J Bone Joint Surg 99:897–904PubMed
15.
Desai N, Bjornsson H, Samuelsson K, Karlsson J, Forssblad M (2014) Outcomes after ACL reconstruction with focus on older patients: results from The Swedish National Anterior Cruciate Ligament Register. Knee Surg Sports Traumatol Arthrosc 22:379–386PubMed
16.
Dudhia J (2005) Aggrecan, aging and assembly in articular cartilage. Cell Mol Life Sci 62:2241–2256PubMed
17.
Englund M, Lohmander LS: Risk factors for symptomatic knee osteoarthritis fifteen to twenty-two years after meniscectomy. Arthritis Rheum 50:2811–2819
18.
Felson DT, Goggins J, Niu JB, Zhang YQ, Hunter DJ (2004) The effect of body weight on progression of knee osteoarthritis is dependent on alignment. Arthritis Rheum 50:3904–3909PubMed
19.
Felson DT, Zhang YQ, Hannan MT, Naimark A, Weissman B, Aliabadi P et al (1997) Risk factors for incident radiographic knee osteoarthritis in the elderly—the Framingham study. Arthritis Rheum 40:728–733PubMed
20.
Harris K, Driban JB, Sitler MR, Cattano NM, Hootman JM (2015) Five-year clinical outcomes of a randomized trial of anterior cruciate ligament treatment strategies: an evidence-based practice paper. J Athl Train 50:110–112PubMedPubMedCentral
21.
Heijink A, Gomoll AH, Madry H, Drobnic M, Filardo G, Espregueira-Mendes J et al (2012) Biomechanical considerations in the pathogenesis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 20:423–435PubMed
22.
Jiang LY, Tian WJ, Wang YC, Rong JS, Bao CD, Liu YP et al (2012) Body mass index and susceptibility to knee osteoarthritis: a systematic review and meta-analysis. Jt Bone Spine 79:291–297
23.
Joseph AM, Collins CL, Henke NM, Yard EE, Fields SK, Comstock RD (2013) A multisport epidemiologic comparison of anterior cruciate ligament injuries in high school athletics. J Athl Train 48:810–817PubMedPubMedCentral
24.
25.
Lohmander LS, Englund PM, Dahl LL, Roos EM (2007) The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 35:1756–1769PubMed
26.
Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50:3145–3152PubMed
27.
Losina E, Weinstein AM, Reichmann WM, Burbine SA, Solomon DH, Daigle ME et al (2013) Lifetime risk and age at diagnosis of symptomatic knee osteoarthritis in the US. Arthritis Care Res (Hoboken) 65:703–711
28.
Magnussen RA, Borchers JR, Pedroza AD, Huston LJ, Haas AK, Spindler KP et al (2018) Risk factors and predictors of significant chondral surface change from primary to revision anterior cruciate ligament reconstruction a MOON and MARS cohort study. Am J Sports Med 46:557–564PubMed
29.
Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach BR Jr et al (2014) Incidence and trends of anterior cruciate ligament reconstruction in the United States. Am J Sports Med 42:2363–2370PubMed
30.
Melton JTK, Murray JR, Karim A, Pandit H, Wandless F, Thomas NP (2011) Meniscal repair in anterior cruciate ligament reconstruction: a long-term outcome study. Knee Surg Sports Traumatol Arthrosc 19:1729–1734PubMed
31.
Mihata LCS, Beutler AI, Boden BP (2006) Comparing the incidence of anterior cruciate ligament injury in collegiate lacrosse, soccer, and basketball players—implications for anterior cruciate ligament mechanism and prevention. Am J Sports Med 34:899–904PubMed
32.
Nordenvall R, Bahmanyar S, Adami J, Mattila VM, Fellander-Tsai L (2014) Cruciate ligament reconstruction and risk of knee osteoarthritis: the association between cruciate ligament injury and post-traumatic osteoarthritis. A population based nationwide study in Sweden, 1987–2009. Plos One 9:7
33.
Oiestad BE, Holm I, Engebretsen L, Aune AK, Gunderson R, Risberg MA (2013) The prevalence of patellofemoral osteoarthritis 12 years after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21:942–949PubMed
34.
Roos H, Adalberth T, Dahlberg L, Lohmander LS (1995) Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. Osteoarthr Cartil 3:261–267
35.
Sanders TL, Kremers HM, Bryan AJ, Larson DR, Dahm DL, Levy BA et al (2016) Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study. Am J Sports Med 44:1502–1507PubMed
36.
Schmitt LC, Paterno MV, Hewett TE (2012) The impact of quadriceps femoris strength asymmetry on functional performance at return to sport following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 42:750–759PubMedPubMedCentral
37.
Sharma L, Lou C, Cahue S, Dunlop DD (2000) The mechanism of the effect of obesity in knee osteoarthritis—the mediating role of malalignment. Arthritis Rheum 43:568–575PubMed
38.
Spindler KP, Huston LJ, Wright RW, Kaeding CC, Marx RG, Amendola A et al (2011) The prognosis and predictors of sports function and activity at minimum 6 years after anterior cruciate ligament reconstruction a population cohort study. Am J Sports Med 39:348–359PubMed
39.
Thomas AC, Hubbard-Turner T, Wikstrom EA, Palmieri-Smith RM (2017) Epidemiology of posttraumatic osteoarthritis. J Athl Train 52:491–496PubMedPubMedCentral
40.
Tourville TW, Johnson RJ, Slauterbeck JR, Naud S, Beynnon BD (2013) Assessment of early tibiofemoral joint space width changes after anterior cruciate ligament injury and reconstruction a matched case-control study. Am J Sports Med 41:769–778PubMedPubMedCentral
41.
von Porat A (2004) High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Ann Rheum Dis 63:269–273
42.
Metadata
Title
Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstruction
Authors
Stephan G. Bodkin
Brian C. Werner
Lindsay V. Slater
Joseph M. Hart
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05461-y

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