Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Mar 18, 2017; 8(3): 212-217
Published online Mar 18, 2017. doi: 10.5312/wjo.v8.i3.212
Anterior cruciate ligament reconstruction and knee osteoarthritis
Nikolaos K Paschos
Nikolaos K Paschos, Department of Orthopaedic Surgery, Penn Sports Medicine, University of Pennsylvania Health System, Philadelphia, PA 19104, United States
Author contributions: Paschos NK developed the idea and wrote the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Nikolaos K Paschos, MD, PhD, Department of Orthopaedic Surgery, Penn Sports Medicine, University of Pennsylvania Health System, 235 S 33rd St, Philadelphia, PA 19104, United States. paschos.nikolaos@gmail.com
Telephone: +1-215-8824440 Fax: +1-800-7897366
Received: September 1, 2016
Peer-review started: September 5, 2016
First decision: September 29, 2016
Revised: October 16, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: March 18, 2017

Anterior cruciate ligament (ACL) injury is a traumatic event that can lead to significant functional impairment and inability to participate in high-level sports-related activities. ACL reconstruction is considered the treatment of choice for symptomatic ACL-deficient patients and can assist in full functional recovery. Furthermore, ACL reconstruction restores ligamentous stability to normal, and, therefore, can potentially fully reinstate kinematics of the knee joint. As a consequence, the natural history of ACL injury could be potentially reversed via ACL reconstruction. Evidence from the literature is controversial regarding the effectiveness of ACL reconstruction in preventing the development of knee cartilage degeneration. This editorial aims to present recent high-level evidence in an attempt to answer whether ACL injury inevitably leads to osteoarthritis and whether ACL reconstruction can prevent this development or not.

Keywords: Anterior cruciate ligament, Osteoarthritis, Anterior cruciate ligament reconstruction, Prevention of osteoarthritis, Meniscus tear, Anterior cruciate ligament tear

Core tip: This editorial aims to present recent evidence in an attempt to answer the following questions: (1) does anterior cruciate ligament (ACL) injury inevitably leads to osteoarthritis (OA)? (2) can ACL reconstruction prevent cartilage degeneration and to what extend is this possible? and (3) what are the risk factors for OA development after ACL injury?