Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Aug;16(8):897-902.
doi: 10.1016/j.joca.2007.11.005. Epub 2008 Jan 22.

Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis

S Amin  1 , A Guermazi, M P Lavalley, J Niu, M Clancy, D J Hunter, M Grigoryan, D T Felson
Affiliations

Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis

S Amin et al. Osteoarthritis Cartilage. 2008 Aug.

Abstract

Objective: To determine whether a complete anterior cruciate ligament (ACL) tear, a frequent incidental finding on magnetic resonance imagings (MRIs) of individuals with established knee osteoarthritis (OA), increases the risk for further knee OA progression.

Methods: We examined 265 participants (43% women) with symptomatic knee OA in a 30-month, prospective, natural history study of knee OA. The more symptomatic knee was imaged using MRI at baseline, 15 and 30 months. Cartilage was scored at the medial and lateral tibiofemoral joint and at the patellofemoral joint using the Whole-Organ MRI Score (WORMS) semi-quantitative method. Complete ACL tear was determined on baseline MRI. At each visit, knee pain was assessed using a knee-specific visual analog scale and physical function was assessed using the Western Ontario and McMaster Universities (WOMAC) physical function subscale.

Results: There were 49 participants (19%) with complete ACL tear at baseline. Adjusting for age, body mass index, gender and baseline cartilage scores, complete ACL tear increased the risk for cartilage loss at the medial tibiofemoral compartment [odds ratio (OR): 1.8, 95% confidence interval (CI): 1.1, 3.2]. However, following adjustment for the presence of medial meniscal tears, no increased risk for cartilage loss was further seen (OR: 1.1, 95% CI: 0.6, 1.8). Knee pain and physical function were similar over follow-up between those with and without a complete ACL tear.

Conclusions: Individuals with knee OA and incidental complete ACL tear have an increased risk for cartilage loss that appears to be mediated by concurrent meniscal pathology. The presence of a complete ACL tear did not influence the level of knee pain or physical function over short-term follow-up.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Cartoon of the knee (sagittal view) and patella illustrating the 5 cartilage plates of the tibiofemoral joint (central femur, posterior femur, anterior tibia, central tibia, posterior tibia) and 4 plates of the patellofemoral joint (medial and lateral patella and anterior femur). A=anterior; C=central; P=posterior; M=medial; L=lateral.
Figure 2
Figure 2
Sagittal proton density MR image showing complete ACL tear (arrows) with normal appearance of the posterior cruciate ligament (PCL) (arrowhead).
See this image and copyright information in PMC

References

    1. Hill CL, Seo GS, Gale D, Totterman S, Gale ME, Felson DT. Cruciate ligament integrity in osteoarthritis of the knee. Arthritis & Rheumatism. 2005;52(3):794–799. - PubMed
    1. Link TM, Steinbach LS, Ghosh S, Ries M, Lu Y, Lane N, et al. Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology. 2003;226(2):373–381. - PubMed
    1. Chan WP, Lang P, Stevens MP, Sack K, Majumdar S, Stoller DW, et al. Osteoarthritis of the knee: comparison of radiography, CT, and MR imaging to assess extent and severity. AJR. American Journal of Roentgenology. 1991;157(4):799–806. - PubMed
    1. Cushner FD, La Rosa DF, Vigorita VJ, Scuderi GR, Scott WN, Insall JN. A quantitative histologic comparison: ACL degeneration in the osteoarthritic knee. Journal of Arthroplasty. 2003;18(6):687–692. - PubMed
    1. Chan WP, Peterfy C, Fritz RC, Genant HK. MR diagnosis of complete tears of the anterior cruciate ligament of the knee: importance of anterior subluxation of the tibia. AJR. American Journal of Roentgenology. 1994;162(2):355–360. - PubMed

Publication types

MeSH terms