Which determinants predict tibiofemoral and patellofemoral osteoarthritis after anterior cruciate ligament injury? A systematic review

• Published in: British Journal of Sports Medicine Vol. 49; no. 15; pp. 975 - 983
• Main Authors: van Meer, Belle L, Meuffels, Duncan E, van Eijsden, Wilbert A, Verhaar, Jan A N, Bierma-Zeinstra, Sita M A, Reijman, Max
• Format: Journal Article Book Review
• Language: English
• Published: England BMJ Publishing Group 01.08.2015; BMJ Publishing Group LTD
• Subjects: Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Arthritis; Humans; Joint surgery; Knee; Ligaments; Osteoarthritis, Knee - diagnostic imaging; Osteoarthritis, Knee - etiology; Patellofemoral Joint; Physical Examination; Postoperative Complications - etiology; Radiography; Risk Factors; Rupture - complications; Rupture - surgery; Sports injuries; Sports medicine; Tibia; Tibial Meniscus Injuries; Treatment Outcome; Osteoarthritis; ACL
• ISSN: 0306-3674; 1473-0480
• DOI: 10.1136/bjsports-2013-093258

BackgroundAnterior cruciate ligament (ACL) injury is an important risk factor for development of knee osteoarthritis (OA). To identify those ACL injured patients at increased risk for knee OA, it is necessary to understand risk factors for OA.AimTo summarise the evidence for determinants of (1) tibiofemoral OA and (2) patellofemoral OA in ACL injured patients.MethodsMEDLINE, EMBASE, Web of Science and CINAHL databases were searched up to 20 December 2013. Additionally, reference lists of eligible studies were manually and independently screened by two reviewers. 2348 studies were assessed for the following main inclusion criteria: ≥20 patients; ACL injured patients treated operatively or non-operatively; reporting OA as outcome; description of relationship between OA outcome and determinants; and a follow-up period ≥2 years. Two reviewers extracted the data, assessed the risk of bias and performed a best-evidence synthesis.ResultsSixty-four publications were included and assessed for quality. Two studies were classified as low risk of bias. Medial meniscal injury/meniscectomy showed moderate evidence for influencing OA development (tibiofemoral OA and compartment unspecified). Lateral meniscal injury/meniscectomy showed moderate evidence for no relationship (compartment unspecified), as did time between injury and reconstruction (tibiofemoral and patellofemoral OA).ConclusionsMedial meniscal injury/meniscectomy after ACL rupture increased the risk of OA development. In contrast, it seems that lateral meniscal injury/meniscectomy has no relationship with OA development. Our results suggest that time between injury and reconstruction does not influence patellofemoral and tibiofemoral OA development. Many determinants showed conflicting and limited evidence and no determinant showed strong evidence.