Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age

Roos, Harald; Adalberth, Torsten; Dahlberg, Leif; Lohmander, L. Stefan

doi:10.1016/s1063-4584(05)80017-2

Cited by 484 publications

(345 citation statements)

References 28 publications

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“…Although more subjects with complete ACL tears recalled a significant knee injury than those with intact ACLs, this still only accounted for just under half of the ACL-deficient subjects. Not only does the severity of knee OA increase with time following an ACL injury, but OA changes appear sooner when patients are older at the time of injury (5). The interval between ACL injury and significant knee symptoms due to OA may be as long as 30 years (18), providing one explanation for the low recall of significant injury in our study.…”

Section: Discussionmentioning

confidence: 73%

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Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

143

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Objective. To evaluate, using magnetic resonance imaging (MRI), the prevalence of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) rupture in knees with symptomatic osteoarthritis (OA) compared with those without OA, and the relationship to pain and recalled injury.Methods. MRI and plain radiography of the knee were performed in a group of 360 subjects with painful knee OA (cases; 66.7% male, mean age 67.1 years) and 73 without knee pain (controls; 57.5% male, mean age 66.1 years). MRIs were read for the presence or absence of complete or partial ACL or PCL tear. Subjects with knee pain were asked to quantify severity of pain on a visual analog scale and to report whether they could recall a significant knee injury (requiring use of a cane or crutches). We compared the prevalence of ACL and PCL rupture in those with and those without knee pain and also evaluated whether, in cases, there was any association with recalled knee injury.Results. The proportion of cases who had complete ACL rupture was 22.8%, compared with 2.7% of controls (P ‫؍‬ 0.0004). PCL rupture was rare both in cases (0.6%) and in controls (0%). Cases with ACL rupture had more severe radiologic OA (P < 0.0001) and were more likely to have medial joint space narrowing (P < 0.0001) than cases with intact ACLs, but did not have higher pain scores. Among cases, only 47.9% of those with complete ACL tears reported a previous knee injury, compared with 25.9% of those without complete ACL tears (P ‫؍‬ 0.003).Conclusion. ACL rupture is more common among those with symptomatic knee OA compared with those without knee OA. Fewer than half of subjects with ACL rupture recall a knee injury, suggesting that this risk factor for knee OA is underrecognized.

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Section: Discussionmentioning

confidence: 73%

“…Rupture of the anterior cruciate ligament (ACL) is known to lead to premature osteoarthritis (OA) of the knee (1)(2)(3)(4)(5). However, the prevalence of ACL and posterior cruciate ligament (PCL) rupture among those with established knee OA and its relationship with pain in those with knee OA or with recalled injury are unknown.…”

mentioning

confidence: 99%

Cruciate ligament integrity in osteoarthritis of the knee

Hill¹,

Seo²,

Gale³

et al. 2005

Arthritis & Rheumatism

143

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“…Acute traumatic joint injury in young adults leads to an increased risk of developing osteoarthritis (OA) later in life (1)(2)(3), despite efforts to intervene in this process by surgically stabilizing injured joints (4). Although the mechanism by which injury leads to tissue degeneration remains to be elucidated, several injuryrelated factors may contribute to the development of OA.…”

mentioning

confidence: 99%

Mechanical injury of cartilage explants causes specific time‐dependent changes in chondrocyte gene expression

Lee

Fitzgerald

DiMicco

et al. 2005

Arthritis & Rheumatism

199

172

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Objective. Joint injury in young adults leads to an increased risk of developing osteoarthritis (OA) later in life. This study was undertaken to determine if injurious mechanical compression of cartilage explants results in changes at the level of gene transcription that may lead to subsequent degradation of the cartilage.Methods. Cartilage was explanted from the femoropatellar groove of newborn calves. Levels of messenger RNA encoding matrix molecules, proteases, their natural inhibitors, transcription factors, and cytokines were assessed in free swelling control cultures as compared with cartilage cultures at 1, 2, 4, 6, 12, and 24 hours after application of a single injurious compression.Results. Gene-expression levels measured in noninjured, free swelling cartilage varied over 5 orders of magnitude. Matrix molecules were the most highly expressed of the genes tested, while cytokines, matrix metalloproteinases (MMPs), aggrecanases (ADAMTS-5), and transcription factors showed lower expression levels. Matrix molecules showed little change in expression after injurious compression, whereas MMP-3 increased ϳ250-fold, ADAMTS-5 increased ϳ40-fold, and tissue inhibitor of metalloproteinases 1 increased ϳ12-fold above the levels in free swelling cultures. Genes typically used as internal controls, GAPDH and ␤-actin, increased expression levels ϳ4-fold after injury, making them unsuitable for use as normalization genes in this study. The expression levels of tumor necrosis factor ␣ and interleukin-1␤, cytokines known to be involved in the progression of OA, did not change in the chondrocytes after injury. Conclusion.Changes in the level of gene expression after mechanical injury are gene specific and time dependent. The quantity of specific proteins may be altered as a result of these changes in gene expression, which may eventually lead to degradation at the tissue level and cause a compromise in cartilage structure and function.

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“…Meniscal injury is quite common (12), second in frequency only to ligamentous strain (9,32,48,56,93). It is the most common injury sustained by athletes (100) and i s the predominant injury associated with chondral damage beyond the third decade of life (29).…”

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confidence: 99%

Longitudinal characterization of synovial fluid biomarkers in the canine meniscectomy model of osteoarthritis

Lindhorst

Vail

Guilak

et al. 2000

Journal Orthopaedic Research

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Summary: Damage to the meniscus can lead to posttraumatic osteoarthritis. Early markers of joint injury and tissue disease may be useful in developing and administering clinical treatmenl. We investigated the effects of total medial meniscectomy on biomarkers measurcd serially in synovial lavage fluid each month for 3 months. Following meniscectomy in dogs, four biomarkers were evaluated: cartilage oligomeric matrix protein, keratan sulfate epitope (5D4). the 3R3(-) neoepitope of chondroitin-(,-sulfate, and the 3B3(+) chondroitinasegenerated epitope of chondroitin-6-sulfate. Meniscectomy led to statistically significant elevations of all four biomarkers, with levels peaking at 4 weeks. By 12 weeks. the level of thc SD4 epitopc returned to the prcoperative baseline level whereas that of cartilage oligomeric matrix protein. 3B3(-), and 3B3(+) remained above the baseline. Concentrations of these biomarkers in the knees not operated on did not change significantly from the baseline. The levels of cartilage oligomeric matrix protein and 3B3(-) relativc to 3B3(+) rcrnained constant in all knees. In contrast. the level of SD4 relativc to 3B3(+) declined over time in the knee operated on but remained constant in the knee not operated on. These results demonstrate a quantitative change in the molecular componenls of synovial fluid after meniscectomy. as well as a qualitative change evinced by an alteration in the relative proportions of these epitopes. Extensive analyses showed a strong correlation between serum levcls of 3B3( -) from thc femorai and cephalic veins; however, serum 3B3(-) was not correlated with synovial h i d 3B3( -). These findings support the hypothesis that the conccntrations of select cartilage biomarkers in synovial fluid are altered following meniscectomy and are promising tools for objectively monitoring the induction of osteoarthritis in this model system.The menisci have been shown to be critical for normal function and health of the knee joint (42,78), serving crucial roles in load transmission (3), shock absorption (86), joint congruence (59) and stability (63), and likely proprioception (26,31,80,112). Meniscal injury is quite common (12), second in frequency only to ligamentous strain (9,32,48,56,93). It is the most common injury sustained by athletes (100) and i s the predominant injury associated with chondral damage beyond the third decade of life (29). Observations of the natural history of meniscal damage reveal deleterious long-term consequences. As many as 20-60% of patients with an isolated injury of the meniscus had radiographic signs of joint degeneration (32.94). Knee injury may occur at an early age, with the first radiographic signs of osteoarthritis ensuing, on average,

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Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age

Cited by 484 publications

References 28 publications

Cruciate ligament integrity in osteoarthritis of the knee

Cruciate ligament integrity in osteoarthritis of the knee

Mechanical injury of cartilage explants causes specific time‐dependent changes in chondrocyte gene expression

Longitudinal characterization of synovial fluid biomarkers in the canine meniscectomy model of osteoarthritis

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