Factors associated with knee osteoarthritis two years after anterior cruciate ligament reconstruction

To determine factors that are associated with the presence and severity of radiologically confirmed knee osteoarthritis (OA) two years after anterior cruciate ligament reconstruction (ACLR).

Forty-one athletes with two years of ACLR participated in the study and completed the International Knee Documentation Committee 2000 (IKDC2000)and knee injury and osteoarthritis outcome score (KOOS) questionnaires. Limb-to-limb knee ROM differences were measured. Athletes completed knee radiographs. Medial- and lateral-compartment-OA were graded using Kellgren-Lawrence (KL) grades (Non-OA group (KL:≤1), OA group (KL:≥2; moderate (KL:2); severe (KL:3,4)).

Medial-compartment-OA was found in 31.7% of athletes (Moderate:17.1%, Severe:14.6%) and lateral-compartment-OA in 19.5% (Moderate:12.2%, severe:7.3%). Age (r = 0.306) and BMI (r = 0.382) (p ≤ 0.014) correlated with medial-compartment-OA; while age (r = 0.433), BMI (r = 0.388), meniscus injury (r = 0.378), and injury-to-surgery time (r:0.376) (p ≤ 0.022) correlated with severe medial-compartment-OA. KOOS-Sport/Recreation (r = -0.386), IKDC 2000 (r = -0.343), and knee flexion ROM (r = -0.343) (p = 0.014) correlated with lateral-compartment-OA, while KOOS-Sport/Recreation (r = -0.376, p = 0.017) correlated with severe lateral-compartment-OA.

Older athletes and high BMI were associated with medial-compartment-OA, while older athletes, high BMI, longer injury-to-surgery duration, and having a meniscus injury were associated with severe medial-compartment-OA. Lower KOOS-Sport/Recreation and IKDC2000 scores, and knee flexion ROM were associated with lateral-compartment-OA, while low KOOS-Sport/Recreation score was associated with severe lateral-compartment-OA.