Knee Injury? Surgery Won't Cut Arthritis Risk

Repairing ACL or Meniscal Cartilage Knee Injury Does Not Prevent Future Knee Osteoarthritis, Study Finds

By Joanna Broder
WebMD Health News

Reviewed By Laura J. Martin, MD

June 29, 2010 -- Having surgery to repair an anterior cruciate ligament (ACL) or meniscal cartilage knee injury does not reduce a person's chance of later developing knee osteoarthritis, says a study published in the August print issue of the journal Radiology.

The study followed up on 326 patients who had been previously diagnosed with persistent knee problems 10 years earlier.

Findings showed that regardless of whether patients had surgery for torn ACL or meniscal cartilage injuries in their knees, knee osteoarthritis could be predicated from risk factors originally found on magnetic resonance imaging or MRI.

"This study proves that meniscal and cruciate ligament lesions increase the risk of developing specific types of knee osteoarthritis," Kasper Huetink, MD, the study's lead author, says in a written statement. "Surgical therapy does not decrease that risk." Huetink is a resident radiologist at Leiden University Medical Center in the Netherlands.

The ACL, one of four ligaments that link the bones in the knee, is the most commonly injured ligament. About 50% of all ACL injuries will lead to damage in other areas of the knee such as the meniscus, a piece of cartilage that serves as a shock absorber for the knee joints.

Symptoms of knee osteoarthritis include stiffness, pain, reduced knee mobility, and swelling. It is a common health problem, affecting more than 9 million Americans, and tends to develop gradually over a few years.

The current study is a follow-up of a previous study which assessed the diagnostic value of knee MRI imaging relative to arthroscopy in patients with persistent knee problems.

A total of 326 patients (38% of the original group) were included in the present study. Only patients with persistent knee problems lasting for more than four weeks who sought a physician's attention were included.

Researchers gathered data regarding the length and severity of the knee symptoms after three and six months, and after 10 years. They also acquired X-rays and MRI images of the knee that was symptomatic 10 years ago.

Patients with ACL and meniscal tears were found to be at greater risk for developing osteoarthritis. The surgical removal of all or part of a torn meniscus did not reduce that risk, the study found.

"There is a higher risk of developing knee osteoarthritis at specific sites after tearing a meniscus or cruciate ligament," Huetink says. "We showed a direct relationship between injury and long-term consequences, and showed that surgery has no impact on long-term outcomes."

The main limitation of the study was the large number of patients lost to follow-up (62%). Another limitation was the possibility that only patients with lasting knee problems expressed interested in participating.

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SOURCES: Huetink, K. Radiology, August 2010.

Kasper Huetink, MD, resident radiologist, Leiden University Medical Center, Netherlands.

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