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Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstruction

  • Stephan G. BodkinEmail author
  • Brian C. Werner
  • Lindsay V. Slater
  • Joseph M. Hart
KNEE

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.

Keywords

ACL reconstruction Knee injury Post-traumatic osteoarthritis Outcomes Risk factors 

Notes

Funding

This study was not externally funded.

Compliance with ethical standards

Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Ethical approval

All data from PearlDiver are de-identified and anonymous and were, thus, deemed exempt by the University’s Institutional Review Board.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

Authors and Affiliations

  1. 1.Department of KinesiologyUniversity of VirginiaCharlottesvilleUSA
  2. 2.Department of Orthopaedic SurgeryUniversity of Virginia Health SystemCharlottesvilleUSA
  3. 3.Shirley Ryan AbilityLabChicagoUSA

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