Journal of Surgery and Trauma

en An Editorial Perspective on Modifiable Risk Factors Before and After Anterior Cruciate Ligament Reconstruction: Strategies for Optimizing Long-Term Outcomes and Mitigating Osteoarthritis تروما Trauma سردبیری Editorial 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 Anterior cruciate ligament, Osteoarthritis, Reconstruction, Rehabilitation 175 180 http://jsurgery.bums.ac.ir/browse.php?a_code=A-10-539-1&slc_lang=en&sid=1 Ebrahim Piri ebrahimm.piri@gmail.com 0000-0001-9188-9746 No Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden. AmirAli Jafarnezhadgero amiralijafarnezhad@gmail.com 0000-0002-2739-4340 Yes Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran Mahdieh Foroughi mailto:mahdiyehforoughi@student.uma.ac.ir 0009-0002-9163-6268 No Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran