Anterior knee pain following anterior cruciate ligament reconstruction does not increase the risk of patellofemoral osteoarthritis at 15- and 20-year follow-ups.
To prospectively evaluate the relationship between the presence or persistence of anterior knee pain (AKP) during the first 2-years following anterior cruciate ligament reconstruction (ACLR) and patellofemoral osteoarthritis (PFOA) at 15- and 20-years.



This study was ancillary to a long-term prospective cohort study of 221 participants following bone-patellar-tendon-bone ACLR. AKP was assessed at 1- and 2-years post-ACLR using part of the Cincinnati knee score with an additional pain location question (persistence defined as presence at both follow-ups). Radiographic PFOA (definite patellofemoral osteophyte) and symptomatic PFOA (patellofemoral osteophyte, with knee pain during past 4 weeks) was assessed at 15- and 20-years follow-up. We used generalized linear models with Poisson regression to assess the relationship between AKP and PFOA.



Of the 181 participants (82%) who were assessed at 15-years post-ACLR (age 39 ± 9 years; 42% female), 36 (24%) and 33 (22%) had AKP at 1- and 2-years, respectively, while 14 (8%) reported persistent AKP. Radiographic and symptomatic PFOA was observed at 15-years in 130 (72%) and 70 (39%) participants, respectively, and at 20-years in 115 (80%) and 60 (42%) participants, respectively. Neither the presence nor persistence of AKP at 1- and/or 2-years post-ACLR was associated with significantly higher risk of radiographic or symptomatic PFOA at 15- or 20-years (risk ratios <2.1).



Although AKP and PFOA were prevalent, AKP does not appear to be associated with long-term PFOA following ACLR.
Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremburg, Salzburg, Austria; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia. Electronic address: adam.culvenor@pmu.ac.at.
A G
AG
Culvenor
Institute of Physiotherapy, Oslo and Akershus University College of Applied Sciences, Oslo, Norway. Electronic address: Britt-Elin.Oiestad@hioa.no.
B E
BE
Øiestad
Department of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway; Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway. Electronic address: inger.holm@medisin.uio.no.
I
I
Holm
Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway. Electronic address: rgunders@ous-hf.no.
R B
RB
Gunderson
La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Australia. Electronic address: k.crossley@latrobe.edu.au.
K M
KM
Crossley
Norwegian Research Centre for Active Rehabilitation, Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Department of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway. Electronic address: m.a.risberg@nih.no.
M A
MA
Risberg
D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D018771:Arthralgia / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D008297:Male; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D012307:Risk Factors
Anterior cruciate ligament; Anterior knee pain; Osteoarthritis; Patellofemoral joint