Early Patellofemoral Osteoarthritis Features One Year After Anterior Cruciate Ligament Reconstruction: Symptoms and Quality of Life at Three Years

Adam G Culvenor, Natalie J Collins, Ali Guermazi, Jill L Cook, Bill Vicenzino, Timothy S Whitehead, Hayden G Morris, Kay M Crossley

To determine if the presence of MRI osteoarthritis (OA) features in the patellofemoral or tibiofemoral joint (i.e. bone marrow lesions, cartilage lesions, osteophytes) and/or functional impairments, 1-year following anterior cruciate ligament reconstruction (ACLR), can predict Knee injury and Osteoarthritis Outcome Score (KOOS) at 3-years. 93 participants (mean age 29±9years, 56 [60%] men) who had undergone MRI examination and functional testing at 1-year post-ACLR, completed the KOOS at 3-years post-surgery. Multivariate regression models evaluated the prognostic capacity of compartment-specific osteochondral OA features, scored using the MRI OA Knee Score (MOAKS), and functional performance (hop for distance, one-leg-rise), to predict outcome on four KOOS-subscales (pain, symptoms, sport/recreation, quality of life [QOL]). Presence of patellofemoral cartilage lesions 1-year post-ACLR predicted worse score on all KOOS-subscales at 3-years (p≤0.01). Regression coefficients (B), 95% confidence intervals (CI): symptoms -5.1 (-9.1, -1.2); pain -4.0 (-6.7, -1.4); sport/recreation -6.7 (-11.0, -2.4); QOL -8.6 (-15.1, -2.1). No significant associations were found between tibiofemoral MRI features and knee symptoms. Poorer performance on the one-leg-rise test predicted worse KOOS-quality of life (B -6.5, 95%CI -12.4, -0.5, p=0.03). The presence of a patellofemoral articular cartilage lesion and lower one-leg-rise performance at 1-year post-surgery are prognostic for poorer 3-year outcome following ACLR. Particular attention to patellofemoral compartment lesions and functional capacity is warranted during post-operative rehabilitation programs, as these features represent potential targets for therapy aimed at minimizing symptomatic disease progression in these young adults. This article is protected by copyright. All rights reserved.