Prognostic factors for tibiofemoral and patellofemoral osteoarthritis 32-37 years after anterior cruciate ligament injury managed with early surgical repair or rehabilitation alone

Summary Objective Explore prognostic factors for tibiofemoral (TFJ) and patellofemoral (PFJ) radiographic osteoarthritis (ROA) and ‘symptoms plus ROA’ (SOA), 32-37 years following anterior cruciate ligament (ACL) injury. Design Exploratory analysis, longitudinal cohort. Methods In 1980-1985, 251 patients aged 15-40 years with acute ACL rupture were allocated to early augmented or non-augmented repair (5±4 days post-injury) plus rehabilitation, or rehabilitation alone. 127 of 190 participants who completed follow-up questionnaires were eligible. We classified ROA as TFJ/PFJ KL sex, baseline meniscus status). Results 127 patients were aged 58±6 years; BMI 27±4 kg/m2; 28% female; 59% had TFJ-ROA, 48% had TFJ-SOA (including n=9 knee-arthroplasties), 36% had PFJ-ROA; 27% had PFJ-SOA. Baseline meniscus surgery was a prognostic factor for TFJ-ROA (multivariable age-adjusted odds ratio (95% CI): 3.0 (1.2, 7.8)). A single-leg-hop limb symmetry index (LSI) Conclusions These findings are hypothesis generating, research is needed to determine whether ACL-injured individuals with these characteristics benefit from interventions to prevent or delay the onset of osteoarthritis.