title: Osteoarthritis after anterior cruciate ligament reconstruction: the importance of regaining and maintaining full range of motion.
abstract: BACKGROUND
  Several factors have been associated with the development of osteoarthritis after anterior cruciate ligament (ACL) reconstruction, yet little attention has been given to the association between range of motion (ROM) and osteoarthritis after ACL reconstruction. Several studies have shown a link between ROM loss and a higher incidence of osteoarthritis.
  
  
  METHODS
  A search was performed with PubMed (MEDLINE) for English-language level I-IV studies involving the long-term evaluation of ROM and osteoarthritis after ACL reconstruction. Keywords were osteoarthritis, anterior cruciate ligament, and range of motion.
  
  
  RESULTS
  SIX STUDIES CONSIDERED WHETHER ROM WAS A FACTOR IN ASSOCIATION WITH OSTEOARTHRITIS AFTER ACL RECONSTRUCTION: In 3 of these studies, an association was found between loss of knee motion and the development of osteoarthritis, while the other 3 studies failed to identify a significant association. Two studies identified an association between ROM loss and decreased subjective outcomes after ACL reconstruction.
  
  
  CONCLUSIONS
  Previous studies have shown an association between loss of knee ROM and osteoarthritic changes on radiographs in the long term after ACL reconstruction. Loss of ROM and osteoarthritis are also associated with lower subjective scores. Other factors related to osteoarthritis, such as meniscal and articular cartilage status, cannot be modified, but through implementation of a directed rehabilitation program before and after ACL surgery, the achievement of full symmetric ROM can be promoted. More emphasis needs to be placed on careful and precise examination of knee ROM, as well as rehabilitation to achieve and maintain full symmetric ROM in the long term after ACL reconstruction.
authors.affiliation: Shelbourne Knee Center, Indianapolis, Indiana.
authors.forename: K Donald
authors.initials: KD
authors.lastname: Shelbourne
authors.forename: Heather
authors.initials: H
authors.lastname: Freeman
authors.forename: Tinker
authors.initials: T
authors.lastname: Gray