Lisa G Suter1, Savannah R Smith2, Jeffrey N Katz3, Martin Englund4, David J Hunter5, Richard Frobell6, Elena Losina7. 1. Yale School of Medicine, Yale New Haven Health Services Corporation Center for Outcome Research and Evaluation, and VA Connecticut Healthcare System, West Haven. 2. Brigham and Women's Hospital, Boston, Massachusetts. 3. Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts. 4. Lund University, Lund, Sweden, and Boston University School of Medicine, Boston, Massachusetts. 5. University of Sydney and Royal North Shore Hospital, Sydney, New South Wales, Australia. 6. Lund University, Lund, Sweden. 7. Brigham and Women's Hospital, Harvard Medical School, and Boston University School of Public Health, Boston, Massachusetts.
Abstract
OBJECTIVE: To estimate the lifetime risk of knee osteoarthritis (OA) and total knee replacement (TKR) in persons sustaining anterior cruciate ligament (ACL) tear by age 25 years. METHODS: We used the Osteoarthritis Policy Model to project the cumulative incidence of symptomatic knee OA requiring TKR in varying situations: no prevalent or incident injury; isolated ACL tear, surgically treated; isolated ACL tear, nonoperatively treated; or a prevalent history or surgically treated ACL and meniscal tear (MT). We estimated MT prevalence and incidence and increased risk of knee OA associated with ACL injury and MT from published literature. We conducted a range of sensitivity analyses to examine the impact of uncertainty in input parameters. RESULTS: Estimated lifetime risk of symptomatic knee OA was 34% for the cohort with ACL injury and MT, compared to 14% for the no-injury cohort. ACL injury without MT was associated with a lifetime risk of knee OA between 16% and 17%, depending on ACL treatment modality. Estimated lifetime risk of TKR ranged from 6% in the no-injury cohort to 22% for the ACL injury and MT cohort. Subjects in the ACL injury and MT cohort developed OA approximately 1.5 years earlier (55.7 versus 57.1) and underwent TKR approximately 2 years earlier (66 versus 68) than the cohort without knee injuries. CONCLUSION: Sustaining ACL injury early in adulthood leads to greater lifetime risk and earlier onset of knee OA and TKR; concomitant MTs compound this risk. These data provide insight into the impact of sustainable injury prevention interventions in young adults.
OBJECTIVE: To estimate the lifetime risk of knee osteoarthritis (OA) and total knee replacement (TKR) in persons sustaining anterior cruciate ligament (ACL) tear by age 25 years. METHODS: We used the Osteoarthritis Policy Model to project the cumulative incidence of symptomatic knee OA requiring TKR in varying situations: no prevalent or incident injury; isolated ACL tear, surgically treated; isolated ACL tear, nonoperatively treated; or a prevalent history or surgically treated ACL and meniscal tear (MT). We estimated MT prevalence and incidence and increased risk of knee OA associated with ACL injury and MT from published literature. We conducted a range of sensitivity analyses to examine the impact of uncertainty in input parameters. RESULTS: Estimated lifetime risk of symptomatic knee OA was 34% for the cohort with ACL injury and MT, compared to 14% for the no-injury cohort. ACL injury without MT was associated with a lifetime risk of knee OA between 16% and 17%, depending on ACL treatment modality. Estimated lifetime risk of TKR ranged from 6% in the no-injury cohort to 22% for the ACL injury and MT cohort. Subjects in the ACL injury and MT cohort developed OA approximately 1.5 years earlier (55.7 versus 57.1) and underwent TKR approximately 2 years earlier (66 versus 68) than the cohort without knee injuries. CONCLUSION: Sustaining ACL injury early in adulthood leads to greater lifetime risk and earlier onset of knee OA and TKR; concomitant MTs compound this risk. These data provide insight into the impact of sustainable injury prevention interventions in young adults.
Authors: Thomas Hoffelner; Herbert Resch; Philipp Moroder; Jörg Atzwanger; Markus Wiplinger; Wolfgang Hitzl; Mark Tauber Journal: Arthroscopy Date: 2012-01-20 Impact factor: 4.772
Authors: H L Holt; J N Katz; W M Reichmann; H Gerlovin; E A Wright; D J Hunter; J M Jordan; C L Kessler; E Losina Journal: Osteoarthritis Cartilage Date: 2010-10-16 Impact factor: 6.576
Authors: W Zhang; R W Moskowitz; G Nuki; S Abramson; R D Altman; N Arden; S Bierma-Zeinstra; K D Brandt; P Croft; M Doherty; M Dougados; M Hochberg; D J Hunter; K Kwoh; L S Lohmander; P Tugwell Journal: Osteoarthritis Cartilage Date: 2008-02 Impact factor: 6.576
Authors: Paul Neuman; Martin Englund; Ioannis Kostogiannis; Thomas Fridén; Harald Roos; Leif E Dahlberg Journal: Am J Sports Med Date: 2008-05-15 Impact factor: 6.202
Authors: Louise Murphy; Todd A Schwartz; Charles G Helmick; Jordan B Renner; Gail Tudor; Gary Koch; Anca Dragomir; William D Kalsbeek; Gheorghe Luta; Joanne M Jordan Journal: Arthritis Rheum Date: 2008-09-15
Authors: Michael F Masaracchio; Kaitlin Kirker; Parisa Loghmani; Jillian Gramling; Michael Mattia; Rebecca States Journal: Arthrosc Sports Med Rehabil Date: 2022-03-25
Authors: Mark Hurtig; Iman Zaghoul; Heather Sheardown; Tannin A Schmidt; Lina Liu; Ling Zhang; Khaled A Elsaid; Gregory D Jay Journal: J Orthop Res Date: 2018-12-17 Impact factor: 3.494
Authors: Naoaki Ito; Jacob J Capin; Elanna K Arhos; Ashutosh Khandha; Thomas S Buchanan; Lynn Snyder-Mackler Journal: J Orthop Res Date: 2020-08-13 Impact factor: 3.102