Knee injuries associated with increased risk of arthritis

(Reuters Health) – According to a research study, osteoarthritis of the knee is more common in people who have sustained ligament or cartilage injuries that help stabilize the knee joint.

The study found that people with anterior cruciate ligament (ACL) injury were four times more likely to develop knee osteoarthritis. The researchers note in the British Journal of Sports Medicine that people with meniscal cartilage, alone or badociated with an ACL injury, were six times more prone to osteoarthritis.

Estimates are from badyzes of 53 studies previously published with more than one million participants, including approximately 185,000 with these knee injuries.

"The injury itself damages tissue and complete knee recovery is rarely acquired," said Erik Poulsen, senior author of the study, from the University of Southern Denmark in Odense.

"The healing abilities of cartilage and ligaments are much lower because of the scarcity of blood," Poulsen said via email. "This structural change changes the biomechanics of the joint and can lead to osteoarthritis, and the often-significant trauma not only tears the ligament or meniscus, but also causes cartilage and bone damage." . "

The results suggest that meniscal lesions isolated or badociated with ACL lesions may be an even greater risk factor for osteoarthritis than an ACL injury alone, conclude the study authors. Many patients were operated on for an ACL injury, but this did not seem to be as important a risk factor as a meniscal injury.

Eleven studies involving approximately 185,000 people investigated ACL lesions. Patients participating in these studies averaged 28 years at the time of the injury.

Twenty-two other studies focused on meniscal lesions. These studies involved approximately 83,000 people, approximately 38 years old at the time of injury.

In 25 studies involving combined ACL and meniscal lesions, patients were 31 years of age at the time of injury.

Most studies followed patients for at least a decade and the risk of osteoarthritis badociated with knee injuries seemed to increase with time.

Osteoarthritis of the knee is one of the leading causes of pain and disability in the elderly, when flexible tissues located at the ends of the bones wear out. Although it can not be cured, physical therapy or anti-inflammatory medications are often prescribed to relieve pain and improve mobility.

One of the limitations of the badysis is that some of the studies lacked data to know whether patients had osteoarthritis prior to the knee injury, noted the study's authors.

However, several factors may increase the risk of osteoarthritis after a knee injury, including muscle weakness, impaired biomechanics, poor functional ability, such as a decreased ability to jump, and being overweight or overweight. obesity, said Adam Culvenor, a sports medicine researcher at The Trobe. University of Melbourne, Australia.

"Returning to sport after an injury does not seem to be badociated with an increased risk of osteoarthritis in the long term, so we can educate our patients about the importance of optimizing muscle strength and function. to maintain a healthy weight and physical activity, "said Culvenor. "Not involved in the study, said by email. "But it's important to note that, to date, there is no evidence from high-quality randomized controlled trials to demonstrate that post-traumatic OA can be prevented."

SOURCE: https://bit.ly/2QyQdkx British Journal of Sports Medicine, online May 9, 2019.