Review: Researchers unclear whether ACL reconstruction prevents long-term OA development

Review: Researchers unclear whether ACL reconstruction prevents long-term OA development

Researchers from the United States and France used results from a 23-year follow-up of a case series by researchers in Lyon, France and a systematic review of the literature to find the long-term effects of ACL reconstruction, meniscal repair and degenerative change of osteoarthritis on patients with an ACL injury.

“Data from the Lyon series indicate that patients with no evidence of degenerative change on plain films 11 years after surgery are at very low risk to develop osteoarthritis over the next 15 years,” Philippe Neyret, MD, and colleagues wrote in the study. “Similarly, if early evidence of degenerative change is visible on radiographs 11 years following surgery, the risk of significant progression of osteoarthritis over the next 15 years is quite high.”

 

Neyret and colleagues found in their literature review that patients with ACL-deficient knees showed osteoarthritis (OA) in 40% of cases after 15 years, with some studies showing 90% of patients developing OA in long-term follow-up at 25 years and 35 years. However, their literature review provided mixed results for whether ACL reconstruction reduced the long-term incidence of OA.

The researchers noted the meniscus plays an important role at the time of ACL reconstruction: OA risk increased anywhere from twofold to tenfold for patients with a total meniscectomy compared to patients with an intact meniscus, according to the abstract.

Magnussen R. Cartilage. 2013. doi:10.1177/1947603513486559