Skip to main content
SpringerLink
Log in

Posttraumatic anterior cruciate ligament insufficiency as a cause of osteoarthritis in a knee joint

  • Originals
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Summary

The purpose of the present investigation was to examine and describe the osteoarthritic changes that chronic, partial or complete anterior cruciate ligament (ACL) insufficiency causes to the knee joint. The most characteristic findings in 77 patients with average follow-up of eight years were osteophytes and subchondral sclerosis of femoral and tibial medial condyles, tibial eminence and patella, as well as narrowing of medial or lateral joint space. Only five patients (14%) in the group with partial, but 28 (70%) of those with complete insufficiency of the ACL suffered from a clear posttraumatic osteoarthritis of the injured knee. In complete tears, the total extent of these pathological changes per patient was fourfold compared to the patients with partial tear. It was concluded that chronic, posttraumatic insufficiency of the ACL causes characteristic osteoarthritic changes to the injured knee and that the amount of these changes seems to depend on the amount of the insufficiency. Therefore, a quick restoration of the static and dynamic stability of the injured knee must be the privilege of every knee injury patient in order to prevent the development of premature osteoarthritis

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cooke, T.D.V., Dwosh, I.L. Clinical features of osteoarthritis in the elderly. Clin Rheum Dis 1986, 12, 155–172.

    PubMed  Google Scholar 

  2. Kannus, P., Järvinen, M., Kontiala, H. et al. Occurrence of symptomatic knee osteoarthrosis in rural Finland: a prospective follow-up study. Ann Rheum Dis 1987, 46, 804–808.

    PubMed  Google Scholar 

  3. Panush, R., Brown, D.G. Exercise and arthritis. Sports Med 1987, 4, 54–64.

    PubMed  Google Scholar 

  4. Leach, R.E., Baumgard, S., Broom, J. Obesity: Its relationship to osteoarthritis of the knee. Clin Orthop 1973, 93, 271–273.

    PubMed  Google Scholar 

  5. Quinet, R.J. Osteoarthritis: Increased mobility and reducing disability. Geriatrics 1986, 2, 36–42.

    Google Scholar 

  6. Kannus, P., Järvinen, M. Age, overweight, sex, and knee instability: their relationship to the posttraumatic osteoarthrosis of the knee joint. Injury 1988, 19, 105–108.

    PubMed  Google Scholar 

  7. Adams, I.D. Osteoarthrosis and sport. Clin Rheum Dis 1976, 2, 523–541.

    Google Scholar 

  8. Iseki, F., Fujikawa, K. Clinical pictures of osteoarthritis of the knee joint. J Jpn Orthop Assoc 1980, 54, 563–574.

    Google Scholar 

  9. Funk, J.R. Osteoarthritis of the knee following ligamentous injury. Clin Orthop 1983, 172, 154–157.

    PubMed  Google Scholar 

  10. Järvinen, M., Kannus, P. Quadriceps muscle atrophy and long-term recovery after knee ligamentous injury. Ann Chir Gynaecol 1987, 76, 108–113.

    PubMed  Google Scholar 

  11. Jacobsen, K. Osteoarthrosis following insufficiency of the cruciate ligaments in man. Acta Orthop Scand 1977, 48, 520–526.

    PubMed  Google Scholar 

  12. Balkfors, B. The course of knee-ligament injuries. Acta Orthop Scand Suppl 1982, 53, 1–99.

    Google Scholar 

  13. Dejour, H., Walch, G., Deschamps, G., Champat, P. Arthrosis of the knee in chronic anterior cruciate laxity. Rev Chir Orthop 1987, 73, 157–170.

    Google Scholar 

  14. Graham, G.P., Fairclough, J.A. Early osteoarthritis in young sportsmen with severe anterolateral instability of the knee. Injury 1988, 19, 247–248.

    PubMed  Google Scholar 

  15. Kannus, P., Järvinen, M.: Osteoarthrosis in a knee joint due to chronic posttraumatic insufficiency of the medial collateral ligament. Nine-year follow-up. Clin Rheumatol 1988, 7, 200–207.

    PubMed  Google Scholar 

  16. Hughston, J.C., Andrews, J.R., Cross, M.J., Moschi, A. Classification of knee ligament instabilities. Part 1 and 2. J Bone Joint Surg 1976, 58-A, 159–179.

    Google Scholar 

  17. Torg, J.S., Condrad, W., Kalen, V. Clinical diagnosis of anterior cruciate ligament instability in the athlete. Am J Sports Med 1976, 4, 84–93.

    PubMed  Google Scholar 

  18. Kannus, P., Järvinen, M., Paakkala, T. A radiological scoring scale for evaluation of post-traumatic osteoarthritis after knee ligament injuries. Int Orthop 1988, 12, 291–297.

    PubMed  Google Scholar 

  19. Marshall, J.L., Fetto, J.F., Botero, P.M. Knee ligament injuries. A standardized evaluation method. Clin Orthop 1977, 123, 115–129.

    PubMed  Google Scholar 

  20. Kennedy, J.C., Stewart, R., Walker, D.M. Anterolateral rotatory instability of the knee joint. J Bone Joint Surg 1978, 60-A, 1031–1039.

    Google Scholar 

  21. Losee, R.E. Concepts of the pivot shift. Clin Orthop 1983, 172, 45–51.

    PubMed  Google Scholar 

  22. Clancy, W.G., Shelbourne, K.D., Zoellner, G.B. et al. Treatment of knee joint instability secondary to rupture of the posterior cruciate ligament. J Bone Joint Surg 1983, 65-A, 310–322.

    Google Scholar 

  23. Parolie, J.M., Bergfeld, J.A. Long-term results of nonoperative treatment of isolated posterior cruciate ligament injuries in the athlete. Am J Sports Med 1986, 14, 35–38.

    PubMed  Google Scholar 

  24. Kannus, P. Osteoarthrosis of the knee due to chronic posttraumatic insufficiency of the lateral ligament compartment. Eight-year follow-up. Clin Rheumatol 1988, 7, 474–480.

    PubMed  Google Scholar 

  25. Sherman, M.F., Warren, R.F., Marshall, J.L., Savatsky, G.L. A clinical and radiographic analysis of 127 anterior cruciate ligament insufficient knees. Clin Orthop 1988, 227, 229–237.

    PubMed  Google Scholar 

  26. Marshall, J.L. Periarticular osteophytes. Initiation arid formation in the knee of the dog. Clin Orthop 1969, 62, 37–47.

    PubMed  Google Scholar 

  27. Marshall, J.L., Olsson, S.E. Instability of the knee. A long-term experimental study in dogs. J Bone Joint Surg 1971, 53-A, 1561–1570.

    Google Scholar 

  28. O'Donoghue, D.H., Frank, G.R., Jeter, G.L. et al. Repair and reconstruction of the anterior cruciate ligament in dogs — factors influencing longterm results. J Bone Joint Surg 1971, 53-A, 710–718.

    Google Scholar 

  29. Paatsama, S., Sittnikow, K. Early changes in the knee joint due to instability induced by cutting of the anterior cruciate ligament. Acta Radiol Suppl 1972, 319, 169–173.

    PubMed  Google Scholar 

  30. Fairbank, T.J. Knee joint changes after meniscectomy. J Bone Joint Surg 1948, 30-B, 664–670.

    Google Scholar 

  31. Tapper, E.M., Hoover, N.W. Late results after meniscectomy. J Bone Joint Surg 1969, 51-A, 517–526.

    Google Scholar 

  32. Johnson, R.J., Kettelkamp, D.B., Clark, W., Leaverton, P. Factors affecting late results after meniscectomy. J Bone Joint Surg 1974, 56-A, 719–729.

    Google Scholar 

  33. Aho, A.J., Lehto, M.U.K., Kujala, U.M. Repair of the anterior cruciate ligament. Augmentation versus conventional suture of fresh ruptures. Acta Orthop Scand 1986, 57, 354–357.

    PubMed  Google Scholar 

  34. Zarins, B., Rowe, C.R. Combined anterior cruciateligament reconstruction using semitendinosus tendon and iliotibial tract. J Bone Joint Surg 1986, 68-A, 160–177.

    Google Scholar 

  35. Monaco, B.R., Noble, H.B., Bachman, D.C. Incomplete tears of the anterior cruciate ligament and knee locking. JAMA 1982, 47, 1582–1584.

    Google Scholar 

  36. Farguharson-Roberts, M.A., Osborne, A.H. Partial rupture of the anterior cruciate ligament of the knee. J Bone Joint Surg 1983, 65-B, 32–34.

    Google Scholar 

  37. Odensten, M., Lysholm, J., Gillquist, J. The course of partial anterior cruciate ligament ruptures. Am J Sports Med 1985, 13, 183–186.

    PubMed  Google Scholar 

  38. Kannus, P., Järvinen, M. Conservatively treated tears of the anterior cruciate ligament. Long-term results. J Bone Joint Surg 1987, 69-A, 1007–1012.

    Google Scholar 

  39. Sandberg, R., Balkfors, R. Partial rupture of the anterior cruciate ligament. Natural course. Clin Orthop 1987, 220, 176–178.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Tampere Research Station of Sports Medicine, Finland

    P. Kannus M.D. & M. Järvinen

  2. Department of Clinical Sciences, University of Tampere, Teiskontie 35, SF-33520, Tampere, Finland

    P. Kannus M.D. & M. Järvinen

Authors
  1. P. Kannus M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Järvinen
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kannus, P., Järvinen, M. Posttraumatic anterior cruciate ligament insufficiency as a cause of osteoarthritis in a knee joint. Clin Rheumatol 8, 251–260 (1989). https://doi.org/10.1007/BF02030082

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02030082

Key words

Search

Navigation