ACL and meniscal injury, and risk of total knee replacement
A growing body of evidence exists, supporting the long term consequences of acute joint injury on the development of osteoarthritis (OA).
The following study examined the inherent risk of common knee pathologies have on the development of end stage OA resulting in total knee replacement (TKR).
The authors found a 7-fold and 15-fold increase in odds of individuals needing a TKR from OA compared to age and sex matched controls from ACL and meniscal injuries, respectively.
The ACL and meniscus provide structural protection and stability that is required for ADL. Loss of this joint stability over the long term has shown to have deleterious effects on the integrity of the joint and has been correlated with accelerated articular cartilage degeneration. This exposes joint surfaces to excessive peak compressive and shear forces which are thought to result in the development of osteoarthritis.
This matched case-control study was conducted to assess the risk of development of end stage OA from those with a history of ACL or meniscal injury, thus needing further management in the form of TKR surgery. The odds were calculated after those with injury were adjusted for body mass index and previous knee fracture.
The authors concluded that a significant independent risk factor exists for both ACL and meniscal injuries on end stage OA development. Furthermore, they discovered that an individual with a history of ACL or meniscal pathology sought TKR at a significantly younger age than those without previous injury.
The incidence of ACL and meniscal injuries increases annually. Therefore, attention directed toward the effects these pathologies have on long term joint health is of growing concern - as consequences on global health impact are widespread.
Prospective and retrospective research in this area is the quintessential approach health care needs to solve the dilemma that presents to us in the prevention and management of chronic joint disease.
> From: Khan et al., Br J Sports Med (2018-02-12 08:25:53) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd. Click here for the online summary.