Higher Osteoarthritis Risk After ACL Injury?

It’s one thing suffering from and getting over anterior cruciate injury, but a recent study from the Journal of Orthopaedic Research has flagged up an alarming side-effect: the heightened risk of osteoarthritis amongst recovering ACL sufferers.

Osteoarthritis – a condition where joints become damaged, preventing their free movement and causing excessive pain – is the most common form of arthritis in the UK. Nearly nine million people in this country have undergone treatment for osteoarthritis, and it usually kicks in during the late forties. It’s an ailment that affects women more than men and, if you’re over 45, there’s a 33% chance that you’re one of the sufferers.

Unsurprisingly, the most affected joints in this country are the knees. According to Arthritis Research UK, an estimated 4.71 million people here have knee osteoarthritis – and with the onset of increased nationwide obesity and an ageing population, those numbers are expected to increase to 5.4 million at the end of the decade and to 6.4 million by the year 2035. In the US, the medical bills are even more of an issue: osteoarthritis comes only after heart disease, cancer, mental and trauma-related disorders in the list of costliest medical conditions.

How does osteoarthritis develop in ACL sufferers?

The Journal of Orthopaedic Research study – which involved tracking the progress of thirty athletes going through ACL reconstruction over six months – discovered that post-ACL patients multiply their risk of knee arthritis by anything from three to five times more than someone who hasn’t incurred this injury.

There are manifold reasons for this. Agitating the joint with repetitive knee adduction moments (the combination of the ground reaction force that passes medial to the centre of the knee joint, and the perpendicular distance of this force from the centre of the joint – otherwise known as ‘walking on it’) is a key element. Factor in the inability for the cartilage to regenerate itself fully after injury due to the lack of a blood supply, and it’s clear that an ACL procedure could cure one ailment while opening the door to another.

What can be done to avoid osteoarthritis?

Although research into the repair of cartilage injuries is still in its infancy, there’s a feeling that something can be done and soon. Much focus has been directed on the possibilities of stem cell research and one hospital in Switzerland is reporting early successes with a procedure that involves removing cartilage from the nose, then growing and shaping it, and transplanting it in the knee area.

Until then, it’s essential that taking steps as early as possible to implement a post-op rehabilitation programme – and ensuring that patients stick to it – is the best solution at the moment.