G Spahn1, M Schiltenwolf2, B Hartmann3, J Grifka4, G O Hofmann5, H-T Klemm6. 1. Praxisklinik für Unfallchirurgie und Orthopädie Eisenach und Universitätsklinium Jena, Sophienstraße 16, 99817, Eisenach, Deutschland. spahn@pk-eisenach.de. 2. Ambulanz und Tagesklinik für Schmerztherapie, Gutachtenambulanz, Klinik für Orthopädie und Unfallchirurgie, Department Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg, Schlierbacher Landstraße 200 a, 69118, Heidelberg, Deutschland. Marcus.Schiltenwolf@med.uni-heidelberg.de. 3. , Steinbeker Grenzdamm 30 d, 22115, Hamburg, Deutschland. hartmannbernd-hamburg@email.de. 4. Asklepios Klinikum Bad Abbach GmbH, Kaiser-Karl-V.-Allee 3, 93077, Bad Abbach, Deutschland. j.grifka@asklepios.com. 5. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Berufsgenossenschaftlichen Klinik Bergmannstrost Halle/Saale, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland. gunther.hofmann@med.uni-jena.de. 6. Freies Institut für medizinische Begutachtungen Bayreuth/Erlangen, Ludwigstraße 25, 95444, Bayreuth, Deutschland. dr.klemm@fimb.de.
Abstract
AIM: The aim of this review was to evaluate the time-related risk for knee osteoarthritis in patients after ACL injury. MATERIALS AND METHODS: The primary search was carried out in different medical databases with the deadline 12.01.2014. The search strategy for the evaluation was [ACL] AND [osteoarthritis] including "all fields". All 1656 title/abstracts were reviewed by two independent researchers who selected 140 papers for full text review. Finally, a total of 21 relevant publications were identified for inclusion in this current paper. RESULTS: The incidence of knee osteoarthritis rises significantly over time. Two years after injury it was 6.9%, after 5 years 32.2%, after 7 years 36.3%, and after 10 years 79.6%. At the same time, the crude relative risk of OA rises as the time interval since injury increases. The relative risk of OA has already doubled by 2 years after ACL injury). By 7 years it has increased fivefold and compared with OA status at the time of injury it is still increasing significantly after 10 years. CONCLUSIONS: The ACL injury is a significant risk factor for the development of early-onset secondary knee osteoarthritis. Within 5 years of the injury the knee shows clear signs of osteoarthritis on MRI. However, these lesions are often not associated with any clinical signs. Knee osteoarthritis as a severe disease starts 8 years or later after the injury, when it requires treatment.
AIM: The aim of this review was to evaluate the time-related risk for knee osteoarthritis in patients after ACL injury. MATERIALS AND METHODS: The primary search was carried out in different medical databases with the deadline 12.01.2014. The search strategy for the evaluation was [ACL] AND [osteoarthritis] including "all fields". All 1656 title/abstracts were reviewed by two independent researchers who selected 140 papers for full text review. Finally, a total of 21 relevant publications were identified for inclusion in this current paper. RESULTS: The incidence of knee osteoarthritis rises significantly over time. Two years after injury it was 6.9%, after 5 years 32.2%, after 7 years 36.3%, and after 10 years 79.6%. At the same time, the crude relative risk of OA rises as the time interval since injury increases. The relative risk of OA has already doubled by 2 years after ACL injury). By 7 years it has increased fivefold and compared with OA status at the time of injury it is still increasing significantly after 10 years. CONCLUSIONS: The ACL injury is a significant risk factor for the development of early-onset secondary knee osteoarthritis. Within 5 years of the injury the knee shows clear signs of osteoarthritis on MRI. However, these lesions are often not associated with any clinical signs. Knee osteoarthritis as a severe disease starts 8 years or later after the injury, when it requires treatment.
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