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Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
Abstract: (90 Views)
Abstract
Anterior cruciate ligament reconstruction (ACLR) is a common orthopedic procedure, yet individuals post-ACLR face a significantly elevated risk of developing post-traumatic osteoarthritis (PTOA), exceeding 50% within 10–15 years. This narrative synthesis interprets current evidence and clinical viewpoints to highlight modifiable risk factors influencing long-term outcomes and proposes actionable strategies for joint preservation. This perspective utilizes a narrative synthesis approach to interpret the existing literature. The search strategy involved utilizing keywords, such as "anterior cruciate ligament reconstruction," "post-traumatic osteoarthritis," "rehabilitation," and "modifiable risk factors" across databases, including PubMed and Scopus, to inform the presented synthesis spanning recent years. Key modifiable risk factors are categorized into pre-operative and post-operative phases. Pre-operatively, factors, such as quadriceps weakness, loss of full extension, aberrant movement patterns, joint effusion, and low psychological readiness, are critical targets. Post-operatively, persistent strength deficits, poor movement quality, inadequate load management, and elevated body mass index are associated with increased PTOA risk. Evidence-based strategies, such as pre-habilitation, criterion-based rehabilitation, neuromuscular training, and lifelong maintenance programs, demonstrate a relationship with risk mitigation. The high prevalence of PTOA following ACLR is not inevitable. By systematically addressing modifiable risk factors through targeted, objective, and sustained interventions, clinicians can significantly improve long-term joint health and functional outcomes.
Keywords: Anterior cruciate ligament, Osteoarthritis, Reconstruction, Rehabilitation
Anterior cruciate ligament reconstruction (ACLR) is a common orthopedic procedure, yet individuals post-ACLR face a significantly elevated risk of developing post-traumatic osteoarthritis (PTOA), exceeding 50% within 10–15 years. This narrative synthesis interprets current evidence and clinical viewpoints to highlight modifiable risk factors influencing long-term outcomes and proposes actionable strategies for joint preservation. This perspective utilizes a narrative synthesis approach to interpret the existing literature. The search strategy involved utilizing keywords, such as "anterior cruciate ligament reconstruction," "post-traumatic osteoarthritis," "rehabilitation," and "modifiable risk factors" across databases, including PubMed and Scopus, to inform the presented synthesis spanning recent years. Key modifiable risk factors are categorized into pre-operative and post-operative phases. Pre-operatively, factors, such as quadriceps weakness, loss of full extension, aberrant movement patterns, joint effusion, and low psychological readiness, are critical targets. Post-operatively, persistent strength deficits, poor movement quality, inadequate load management, and elevated body mass index are associated with increased PTOA risk. Evidence-based strategies, such as pre-habilitation, criterion-based rehabilitation, neuromuscular training, and lifelong maintenance programs, demonstrate a relationship with risk mitigation. The high prevalence of PTOA following ACLR is not inevitable. By systematically addressing modifiable risk factors through targeted, objective, and sustained interventions, clinicians can significantly improve long-term joint health and functional outcomes.
Keywords: Anterior cruciate ligament, Osteoarthritis, Reconstruction, Rehabilitation
Type of Study: Editorial |
Subject:
Trauma
Received: 2026/01/8 | Accepted: 2026/05/18 | ePublished ahead of print: 2026/06/7
Received: 2026/01/8 | Accepted: 2026/05/18 | ePublished ahead of print: 2026/06/7
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