Volume 14, Issue 4 (9-2026)
J Surg Trauma 2026, 14(4): 175-180 |
Back to browse issues page
Ethics code: This study is an editorial article.
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Piri E, Jafarnezhadgero A, Foroughi M. An Editorial Perspective on Modifiable Risk Factors Before and After Anterior Cruciate Ligament Reconstruction: Strategies for Optimizing Long-Term Outcomes and Mitigating Osteoarthritis. J Surg Trauma 2026; 14 (4) :175-180
URL: http://jsurgery.bums.ac.ir/article-1-532-en.html
URL: http://jsurgery.bums.ac.ir/article-1-532-en.html
Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
Abstract: (615 Views)
Anterior cruciate ligament reconstruction (ACLR) is a devastating injury, predominantly affecting active individuals. While ACLR is often successful in facilitating a return to sport (RTS), it fails to fully restore the knee to its pre-injury biological state (1). The subsequent development of post-traumatic osteoarthritis (PTOA) represents a major public health concern, leading to pain, functional limitations, and reduced quality of life many years after the initial surgery (2). The etiology of PTOA after ACLR is multifactorial, involving a complex interplay of biological, mechanical, and patient-specific factors. While non-modifiable factors (e.g., age, genetics, concomitant meniscal/chondral injury) contribute to risk, a growing body of evidence points to several modifiable factors that clinicians and patients can target (3). This editorial delineates these factors across the treatment timeline, proposing actionable strategies to optimize outcomes and protect the joint
Type of Study: Editorial |
Subject:
Trauma
Received: 2026/01/8 | Accepted: 2026/05/18 | ePublished ahead of print: 2026/06/7 | Published: 2026/09/1
Received: 2026/01/8 | Accepted: 2026/05/18 | ePublished ahead of print: 2026/06/7 | Published: 2026/09/1
References
1. Fischer AG, Erhart-Hledik JC, Chu CR, Asay JL, Andriacchi TP. Changes in stair ascent biomechanics two to eight years after ACL reconstruction are associated with patient-reported outcomes. Gait & Posture. 2019;69:91-5. [DOI: 10.1016/j.gaitpost.2019.01.029] [DOI:10.1016/j.gaitpost.2019.01.029] [PMID]
2. Wang L-J, Zeng N, Yan Z-P, Li J-T, Ni G-X. Post-traumatic osteoarthritis following ACL injury. Arthritis Res Ther. 2020;22(1):57. [DOI: 10.1186/s13075-020-02156-5] [DOI:10.1186/s13075-020-02156-5] [PMID]
3. Paterno MV, Huang B, Thomas S, Hewett TE, Schmitt LC. Clinical factors that predict a second ACL injury after ACL reconstruction and return to sport: preliminary development of a clinical decision algorithm. Orthop J Sports Med. 2017;5(12):2325967117745279. [DOI: 10.1177/2325967117745279] [DOI:10.1177/2325967117745279] [PMID] [PMCID]
4. Meredith SJ, Rauer T, Chmielewski TL, Fink C, Diermeier T, Rothrauff BB, et al. Return to sport after anterior cruciate ligament injury: Panther symposium ACL injury return to sport consensus group. Orthop J Sports Med. 2020;8(6):2325967120930829. [DOI: 10.1007/s00167-020-06009-1] [DOI:10.1007/s00167-020-06009-1] [PMID]
5. Whittaker JL, Truong LK, Losciale JM, Silvester-Lee T, Miciak M, Pajkic A, et al. Efficacy of the SOAR knee health program: protocol for a two-arm stepped-wedge randomized delayed-controlled trial. BMC Musculoskelet Disord. 2022;23(1):85. [DOI: 10.1186/s12891-022-05019-z] [DOI:10.1186/s12891-022-05019-z] [PMID] [PMCID]
6. Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: The Delaware-Oslo ACL cohort study. Br J Sports Med. 2016;50(13):804-8. [DOI: 10.1136/bjsports-2016-096031] [DOI:10.1136/bjsports-2016-096031] [PMID] [PMCID]
7. Ithurburn MP, Altenburger AR, Thomas S, Hewett TE, Paterno MV, Schmitt LC. Young athletes after ACL reconstruction with quadriceps strength asymmetry at the time of return-to-sport demonstrate decreased knee function 1 year later. Knee Surg Sports Traumatol Arthrosc. 2018;26(2):426-33. [DOI: 10.1007/s00167-017-4678-4] [DOI:10.1007/s00167-017-4678-4] [PMID]
8. Andrade R, Pereira R, van Cingel R, Staal JB, Espregueira-Mendes J. How should clinicians rehabilitate patients after ACL reconstruction? A systematic review of clinical practice guidelines (CPGs) with a focus on quality appraisal (AGREE II). Br J Sports Med. 2020;54(9):512-9. [DOI: 10.1136/bjsports-2018-100310] [DOI:10.1136/bjsports-2018-100310] [PMID]
9. Adhitya IPGS, Kurniawati I, Sawa R, Wijaya TF, Dewi NPAC. The risk factors and preventive strategies of poor knee functions and osteoarthritis after anterior cruciate ligament reconstruction: A narrative review. Phys Ther Res. 2023;26(3):78-88. [DOI: 10.1298/ptr.R0028] [DOI:10.1298/ptr.R0028] [PMID] [PMCID]
10. Bruder AM, Culvenor AG, King MG, Haberfield M, Roughead EA, Mastwyk J, et al. Let's talk about sex (and gender) after ACL injury: A systematic review and meta-analysis of self-reported activity and knee-related outcomes. Br J Sports Med. 2023;57(10):602-10. [DOI: 10.1136/bjsports-2022-106099] [DOI:10.1136/bjsports-2022-106099] [PMID]
11. Praetorius ADA. Anterior cruciate ligament reconstruction with hamstring autograft: Evaluation of a brace free rehabilitation protocol and biomechanical assessment of functional outcome using statistical parametric mapping: Dissertation, Duisburg, Essen, Universität Duisburg-Essen, 2023; 2023. [DOI:10.17185/duepublico/78286]
12. Franco D, Ambrosio L, Za P, Maltese G, Russo F, Vadalà G, et al. Effective prevention and rehabilitation strategies to mitigate non-contact anterior cruciate ligament injuries: A narrative review. Appl Sci (Basel). 2024;14(20):9330.
[Link] [DOI:10.3390/app14209330]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Attribution-NoneCommercial CC BY-NC
