Post-traumatic osteoarthritis diagnosed within 5 years following ACL reconstruction.
PURPOSE
The purpose was to calculate the incidence of osteoarthritis in individuals following Anterior Cruciate Ligament Reconstruction (ACLR) in a large, national database and to examine the risk factors associated with OA development.


METHODS
A commercially available insurance database was queried to identify new diagnoses of knee OA in patients with ACLR. The cumulative incidence of knee OA diagnoses in patients after ACLR was calculated and stratified by time from reconstruction. Odds ratios were calculated using logistic regression to describe factors associated with a new OA diagnosis including age, sex, BMI, meniscus involvement, osteochondral graft use, and tobacco use.


RESULTS
A total of 10,565 patients with ACLR were identified that did not have an existing diagnosis of OA, 517 of which had a documented new diagnosis of knee OA 5 years after ACL reconstruction. When stratified by follow-up time points, the incidence of a new OA diagnosis within 6 months was 2.3%; within a 1-year follow-up was 4.1%; within 2 years, follow-up was 6.2%, within 3 years, follow-up was 8.4%; within 4 years, follow-up was 10.4%; and within 5 years, follow-up was 12.3%. Risk factors for new OA diagnoses were age (OR 2.44, P < 0.001), sex (OR 1.2, P = 0.002), obesity (OR 1.4, P < 0.001), tobacco use (OR = 1.3, P = 0.001), and meniscal involvement (OR 1.2, P = 0.005).


CONCLUSION
Approximately 12% of patients presenting within 5 years following ACLR are diagnosed with OA. Demographic factors associated with an increased risk of a diagnosis of PTOA within 5 years after ACLR are age, sex, BMI, tobacco use, and concomitant meniscal surgery. Clinicians should be cognizant of these risk factors to develop risk profiles in patients with the common goal to achieve optimal long-term outcomes after ACLR.


LEVEL OF EVIDENCE
III.
['Bodkin|Stephan G|SG|http://orcid.org/0000-0001-7595-371X', 'Werner|Brian C|BC|', 'Slater|Lindsay V|LV|', 'Hart|Joseph M|JM|']
D000293:Adolescent D000328:Adult D000070598:Anterior Cruciate Ligament Injuries D059549:Anterior Cruciate Ligament Reconstruction D005260:Female D006801:Humans D015994:Incidence D007719:Knee Joint D008297:Male D000072600:Meniscus D008875:Middle Aged D020370:Osteoarthritis, Knee D011183:Postoperative Complications D012189:Retrospective Studies D012307:Risk Factors D000070600:Tibial Meniscus Injuries D013997:Time Factors D014481:United States D055815:Young Adult
Post-traumatic osteoarthritis ACL reconstruction Risk factors Outcomes Knee injury