Objective: To determine the prevalence and factors associated with knee osteoarthritis (OA) defined by magnetic resonance imaging (MRI) and specific MRI-OA features one year after anterior cruciate ligament reconstruction (ACLR). Methods: Isotropic 3.0T MRI scans were obtained for 111 participants (mean age 30±8years, 71 men) one year post-ACLR and 20 age-, sex- and activity level-matched uninjured controls. The MRI OsteoArthritis Knee Score (MOAKS) was used to score specific OA features. MRI-defined tibiofemoral and patellofemoral OA was evaluated based on published criteria. Logistic regression identified factors associated with MRI-defined OA and specific OA features post-ACLR. Results: Following ACLR, medial and lateral tibiofemoral MRI-OA were observed in 7 (6%) and 12 (11%) participants, respectively, while 19 (17%) participants had patellofemoral MRI-OA. The femoral trochlea was the region most affected by bone marrow lesions (19% of participants), cartilage lesions (31%) and osteophytes (37%). Meniscectomy at the time of ACLR (odds ratio 6.8, 95%CI 2.0 to 23.3) and BMI >25kg.m(-2) (3.0, 1.3 to 6.9) predicted MRI-defined tibiofemoral OA and osteophytes, respectively. Men had higher odds of patellofemoral osteophytes (6.3, 2.4 to 16.2). In uninjured controls, no participant had tibiofemoral or patellofemoral MRI-OA and specific OA features were uncommon. Conclusion: Osteoarthritis one year following ACLR was more common than previously recognised, while being absent in uninjured control knees. The patellofemoral compartment seems to be at particular risk for early OA post-ACLR, especially in men. The association with meniscectomy and BMI demonstrates the construct validity of MRI criteria. This article is protected by copyright. All rights reserved.