Capitol News

The prevalence of early knee osteoarthritis (OA) symptoms among patients after anterior cruciate ligament (ACL) reconstruction is a significant concern, according to new research from Michigan State University's Department of Kinesiology. The study, published in the Journal of Athletic Training in January 2024, highlights the persistence of these symptoms throughout the first year following surgery and underscores the need for early intervention.

Assistant Professor Matthew Harkey, who authored the study, stated, "We’re trying to change the narrative. We see fairly young, active individuals experiencing extensive symptoms, but these symptoms are not interpreted by clinicians as something that may be related to osteoarthritis. Ignoring these symptoms might be setting them up to experience long term decline and function."

ACL reconstruction is an arthroscopic surgical procedure that replaces a torn anterior cruciate ligament in the knee with a graft. According to the National Institutes of Health, approximately 400,000 such procedures are completed annually in the United States.

A previous study from 2017 indicated that around 14 million people in the U.S. suffer from symptomatic early knee OA. In this recent research by MSU scholars, a data set comprising 82 individuals who underwent ACL reconstruction was examined. Each participant completed a survey about their knee pain and symptoms post-surgery. Results showed nearly one-in-four participants reported persistent early arthritis symptoms six to twelve months after surgery.

In April 2024, Harkey will present similar research at the Osteoarthritis Research Society International Conference in Austria using data from 3,200 individuals supplied by the New Zealand ACL Registry. This larger dataset revealed that close to one-in-three had early knee OA symptoms up to 24 months after ACL reconstruction.

Harkey emphasized that not addressing these symptoms promptly could place patients at risk for long-term structural decline. Although his study does not definitively show that patients with lingering symptoms will develop early OA, it raises awareness among athletic trainers about potential issues that could benefit from intervention.

"It’s a bit complex – we can’t outright say arthritis is developing," Harkey noted. "Often, clinicians assume that these post-operative symptoms will naturally improve as patients reengage with their usual activities. However, what we’re seeing suggests these symptoms persist and likely require a targeted approach to manage or improve them."

Harkey suggested interventions such as exercise or physical therapy to help maintain strength and movement but acknowledged barriers within healthcare infrastructure limiting access to sufficient physical therapy sessions under current healthcare plans.

Co-authors of this study affiliated with MSU include Ashley Triplett and Sheeba Joseph from various colleges within MSU; Francesca Genoese from the Department of Kinesiology; and Michael Shingles and Andrew Schorfhaar from Sparrow Hospital.

Looking ahead, Harkey aims to demonstrate how early knee OA following ACL reconstruction may lead to structural joint damage over time.