Related Experiment Video
Updated: Jan 20, 2026
A Reproducible Cartilage Impact Model to Generate Post-Traumatic Osteoarthritis in the Rabbit
Published on: November 21, 2023
Anatomic ACL reconstruction reduces risk of post-traumatic osteoarthritis: a systematic review with minimum 10-year
Benjamin B Rothrauff1, Ahmed Jorge1, Darren de Sa1
1Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, 3200 S. Water St., Pittsburgh, PA, 15203, USA.
Purpose:
To systematically review the literature for radiographic prevalence of osteoarthritis (OA) at a minimum of 10 years following anterior cruciate ligament (ACL) reconstruction (ACLR) with anatomic vs. non-anatomic techniques. It was hypothesized that the incidence of OA at long-term follow-up would be lower following anatomic compared to non-anatomic ACLR.
Methods:
A systematic review was performed by searching PubMed, MEDLINE, EMBASE, and the Cochrane Library, for studies reporting OA prevalence by radiographic classification scales at a minimum of 10 years following ACLR with autograft. Studies were categorized as anatomic if they met or exceeded a score of 8 according the Anatomic ACL Reconstruction Scoring Checklist (AARSC), while those with a score less than 8 were categorized as non-anatomic/non-specified. Secondary outcomes included graft failure and measures of knee stability (KT-1000, Pivot Shift) and functional outcomes [Lysholm, Tegner, subjective and objective International Knee Documentation Committee (IKDC) scores]. OA prevalence on all radiographic scales was recorded and adapted to a normalized scale.
Results:
Twenty-six studies were included, of which 5 achieved a score of 8 on the AARSC. Using a normalized OA classification scale, 87 of 375 patients (23.2%) had diagnosed OA at a mean follow-up of 15.3 years after anatomic ACLR and 744 of 1696 patients (43.9%) had OA at mean follow-up of 15.9 years after non-anatomic/non-specified ACLR. The AARSC scores were 9.2 ± 1.3 for anatomic ACLR and 5.1 ± 1.1 for non-anatomic/non-specified ACLR. Secondary outcomes were relatively similar between techniques but inconsistently reported.
Conclusions:
This study showed that anatomic ACLR, defined as an AARSC score ≥ 8, was associated with lower OA prevalence at long-term follow-up. Additional studies reporting long-term outcomes following anatomic ACLR are needed, as high-level studies of anatomic ACLR are lacking. The AARSC is a valuable resource in performing and evaluating anatomic ACLR. Anatomic ACLR, as defined by the AARSC, may reduce the long-term risk of post-traumatic OA following ACL injury to a greater extent than non-anatomic ACLR.
Level Of Evidence:
IV.
Related Concept Videos
08:42A Reproducible Cartilage Impact Model to Generate Post-Traumatic Osteoarthritis in the Rabbit
11:09Visualization of Knee Joint Degeneration after Non-invasive ACL Injury in Rats
1Department of Kinesiology, University of Connecticut, Storrs, CT; 2Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT; 3Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY; 4Center for Muscle Biology, Department of Physiology, University of Kentucky, Lexington, KY; 5Biomedical Engineering Department, University of Connecticut,...
01:35Types of Risk: Systematic Risk
Market risk refers to the possibility that the overall stock market will decline, impacting the value of all investments. This risk is often driven by macroeconomic factors such as economic recessions, financial crises, or global...
15:04An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
06:28Anterior Cruciate Ligament Transection and Synovial Fluid Lavage in a Rodent Model to Study Joint Inflammation and Posttraumatic Osteoarthritis
01:27Post-traumatic Stress Disorder
Symptoms and Behavioral Manifestations
A spectrum of distressing symptoms characterizes PTSD. Recurrent flashbacks, where individuals involuntarily relive traumatic events,...