Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstruction

Bodkin, Stephan; Werner, Brian C.; Slater, Lindsay V.; Hart, Joseph M.

doi:10.1007/s00167-019-05461-y

Cited by 59 publications

(58 citation statements)

References 43 publications

(53 reference statements)

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“…However, these predicting methods predict late-stage changes leading to joint replacement, but not the early processes leading to potentially reversible tissue damage. Moreover, successfully predicting PTOA within 2 to 3 years in patients after meniscus repair or partial meniscectomy after ACL tear is somewhat expectable, as advanced joint deterioration is known to be associated with both procedures [237,238]. Despite these facts, the impressive aspect is that they have successfully demonstrated that multi-modality measurements could be used for prediction.…”

Section: Summary Outlook and Early Disease Considerationsmentioning

confidence: 99%

An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

Khella

Asgarian

Horvath

et al. 2021

IJMS

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Understanding the causality of the post-traumatic osteoarthritis (PTOA) disease process of the knee joint is important for diagnosing early disease and developing new and effective preventions or treatments. The aim of this review was to provide detailed clinical data on inflammatory and other biomarkers obtained from patients after acute knee trauma in order to (i) present a timeline of events that occur in the acute, subacute, and chronic post-traumatic phases and in PTOA, and (ii) to identify key factors present in the synovial fluid, serum/plasma and urine, leading to PTOA of the knee in 23–50% of individuals who had acute knee trauma. In this context, we additionally discuss methods of simulating knee trauma and inflammation in in vivo, ex vivo articular cartilage explant and in vitro chondrocyte models, and answer whether these models are representative of the clinical inflammatory stages following knee trauma. Moreover, we compare the pro-inflammatory cytokine concentrations used in such models and demonstrate that, compared to concentrations in the synovial fluid after knee trauma, they are exceedingly high. We then used the Bradford Hill Framework to present evidence that TNF-α and IL-6 cytokines are causal factors, while IL-1β and IL-17 are credible factors in inducing knee PTOA disease progresssion. Lastly, we discuss beneficial infrastructure for future studies to dissect the role of local vs. systemic inflammation in PTOA progression with an emphasis on early disease.

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Section: Summary Outlook and Early Disease Considerationsmentioning

confidence: 99%

An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

Khella

Asgarian

Horvath

et al. 2021

IJMS

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“…We used these criteria for participant age and time since surgery to limit the likelihood that participants would be experiencing symptoms or functional limitations related to OA. 3,16 Volunteers were excluded from the study if they reported a history of lower extremity injury in the 6 weeks before data collection, had any history of lower extremity surgery, or had any chronic medical condition that might have affected their ability to participate in physical activity. Weekly moderate-to-vigorous physical activity and daily step-count data from all healthy participants (n ¼ 42) and most ACLR participants (n ¼ 41) were included in a previous study 7 that assessed differences in physical activity outcomes between individuals with and those without a history of ACLR.…”

Section: Participantsmentioning

confidence: 99%

Assessment of Free-Living Cadence Using ActiGraph Accelerometers Between Individuals With and Without Anterior Cruciate Ligament Reconstruction

Lisee

Montoye

Lewallen

et al. 2020

Journal of Athletic Training

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Context Anterior cruciate ligament reconstruction (ACLR) and gait speed are risk factors for developing knee osteoarthritis (OA). Measuring minute-level cadence during free-living activities may aid in identifying individuals at elevated risk of developing slow habitual gait speed and, in the long term, OA. Objective To assess differences in peak 1-minute cadence and weekly time in different cadence intensities between individuals with and without ACLR. Design Cross-sectional study. Setting Short-term, free-living conditions. Patients or Other Participants A total of 57 participants with ACLR (34 women, 23 men; age = 20.9 ± 3.2 years, time since surgery = 28.7 ± 17.7 months) and 42 healthy control participants (22 women, 20 men; age = 20.7 ± 1.7 years). Main Outcome Measure(s) Each participants wore a physical activity monitor for 7 days. Data were collected at 30 Hz, processed in 60-second epochs, and included in the analyses if the activity monitor was worn for at least 10 hours per day over 4 days. Mean daily steps, peak 1-minute cadence, and weekly minutes spent at 60 to 79 (slow walking), 80 to 99 (medium walking), 100 to 119 (brisk walking), ≥100 (moderate- to vigorous-intensity ambulation), and ≥130 (vigorous-intensity ambulation) steps per minute were calculated. One-way analyses of covariance were conducted to determine differences between groups, controlling for height and activity-monitor wear time. Results Those with ACLR took fewer daily steps (8422 ± 2663 versus 10 033 ± 3046 steps; P = .005) and spent fewer weekly minutes in moderate- to vigorous-intensity cadence (175.8 ± 116.5 minutes versus 218.5 ± 137.1 minutes; P = .048) than participants without ACLR. We observed no differences in minutes spent at slow (ACLR = 77.4 ± 40.5 minutes versus control = 83.9 ± 34.3 minutes; P = .88), medium (ACLR = 71.6 ± 40.2 minutes versus control = 82.9 ± 46.8 minutes; P = .56), brisk (ACLR = 115.3 ± 70.3 minutes versus control = 138.3 ± 73.3 minutes; P = .18), or vigorous-intensity (ACLR = 24.3 ± 36.5 minutes versus control = 38.1 ± 60.9 minutes; P = .10) cadences per week. Conclusions Participants with ACLR walked approximately 40 minutes less per week in moderate- to vigorous-intensity cadence than participants without ACLR. Increasing the time spent at cadence ≥100 steps per minute and overall volume of physical activity may be useful as interventional targets to help reduce the risk of early development of OA after ACLR.

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“…Reinjury rates after primary ACL reconstruction (ACLR) have been reported up to 28% for individuals who to return to high levels of physical activity and sports. 1,2 In addition to high reinjury rates, decreased physical activity, 3 lower subjective function, 4 and early onset posttraumatic osteoarthritis 5,6 have challenged contemporary management strategies for patients rehabilitating after ACLR. To effectively manage healthcare decisions following ACL injury, measures of patient function that best identify patients at risk for secondary ACL injury are needed.…”

Section: Introductionmentioning

confidence: 99%

Predicting Anterior Cruciate Ligament Reinjury From Return-to-Activity Assessments at 6 Months Postsurgery: A Prospective Cohort Study

Bodkin

Hertel

Diduch

et al. 2021

Journal of Athletic Training

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Context: Return to activity(RTA) assessments are commonly administered following ACL-Reconstruction(ACLR) to manage post-operative progressions back to activity. To date, there is little knowledge on the clinical utility of these assessments to predict patient outcomes such as secondary ACL injury once returned to activity. Objective: To identify what measures of patient function at 6-months post-ACLR best predict return to activity and second ACL injury at a minimum of 2-years following ACLR. Design: Prospective-cohort Setting: Laboratory Patients: A total of 234 patients with primary, unilateral ACLR completed functional assessments at approximately 6-months post-ACLR. A total of 192(82%) completed follow-up ≥ 2-years post ACLR. Main Outcome Measures: Six-month functional assessments consisted of patient reported outcomes, isokinetic knee flexor and extensor strength, and single-leg hopping. The ability to return to activity and secondary ACL injury were collected at a minimum of two-years following ACLR. Results: In patients who did RTA(n=155), a total of 44(28%) individuals had a subsequent ACL injury; graft n=24(15.5%), contralateral ACL n=20(13%). A greater proportion of females had a secondary injury to the contralateral ACL(15/24, 63%) whereas a greater proportion of males reinjured the ipsilateral ACL graft(15/20, 75%, P=.017) Greater knee extension symmetry at 6-months increased the probability of reinjury(B=.016, P=.048). In patients who RTA before 8-months, every 1% increase in quadriceps strength symmetry at 6-months increased the risk of reinjury by 2.1%(B=.021, P=.05). In patients who RTA after 8-months, every month that RTA was delayed reduced the risk of reinjury by 28.4%(B=−284, P=.042). Conclusions: Patients with more symmetric quadriceps strength at 6-months post ACLR were more likely to experience another ACL rupture, especially in those who returned to sport earlier than 8-months after the index surgery. Clinicians should be cognizant that returning high functioning patients to activity earlier than 8-months post-ACLR may place them at an increased risk for reinjury.

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Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstruction

Cited by 59 publications

References 43 publications

An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

An Evidence-Based Systematic Review of Human Knee Post-Traumatic Osteoarthritis (PTOA): Timeline of Clinical Presentation and Disease Markers, Comparison of Knee Joint PTOA Models and Early Disease Implications

Assessment of Free-Living Cadence Using ActiGraph Accelerometers Between Individuals With and Without Anterior Cruciate Ligament Reconstruction

Predicting Anterior Cruciate Ligament Reinjury From Return-to-Activity Assessments at 6 Months Postsurgery: A Prospective Cohort Study

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