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Can an ACL Injury Become the Cause of Arthritis in the Future?


Knee ligament injuries or ACL tears are dangerous for everyone and are one of the most common athletic injuries and can be particularly devastating for a young athlete, leading to absence from sports teams, significant recovery, and disruption of normal life may arise.

Most athletes along with their parents and coaches get worried about returning back to activity, not what may occur in a few years. But the stark fact is that this injury can cause some serious long-term complications.

The most important joints in the human body are the knees, which are held together by a strong but fragile network of nerves, cartilage, and bones.

The knee ligaments perform the arduous task of holding the thigh bones, the largest in the body, attached to the tibia and fibula.

ACL or also known as the Anterior cruciate ligament and the other ligaments of the knee protect the movements from front to back and vice versa.

However, a sudden stop, twist, or turn can pull it beyond its specific range of motion, which can lead to tears or sprains of the ACL or meniscus (thin cartilage in the knee).

Every year a number of people experience tears. Although tears are more common among athletes yet it is not necessary to include only them.

A torn ACL cannot heal on its own. ACL reconstruction surgery and physical therapy are the two main options available for its treatment.

ACL and Arthritis

Studies have shown that approximately 75 percent of people with an ACL injury show findings of arthritis on X-rays of their knee within 10–15 years of the injury.

These people face the prospect of managing arthritis of the knee in their 30s, at a time when the incidence of arthritis is very low.

Arthritis is more likely to occur in people who have damaged the meniscus cartilage or articular cartilage with ACL tears.

Inflammatory cascades that begin after injury, changes in joint biomechanics because of ACL deficiency, related meniscus injuries, and other factors make it more vulnerable to wear and tear of protective cartilage at the bones end which becomes the cause of osteoarthritis after an injury to the ACL.

Initial injuries can inadvertently damage the cartilage of the joints. With a little bit of self-healing, The damage to the cartilage becomes more pronounced over time. Also, the mechanics of the knee may also change after reconstructive surgery.

The initial symptoms of osteoarthritis usually appear after five to ten years of the injury. Although each ACL tear is different, yet the factors such as repetitive knee injury and weight gain can be the reason for the early onset of arthritis.

Surgical Treatment

Surgical treatment is by far the most popular treatment for ACL reconstruction, where tendon grafts are used to replace the ACL.

People who choose ACL surgery have fewer symptoms of later ACL rupture, have a more predictable return to activity, and probably have a lower risk of developing osteoarthritis than untreated rupture.

The best time for ACL reconstructive surgery is at least three weeks after the injury and subsequent physical therapy is crucial for restoring hamstring and quad strength.

ACL surgery shows positive results for active recovery and keeping the knee from getting worse. Most patients return to pre-surgery activity levels.

Significant damage to the meniscus during an ACL injury, total meniscectomy (surgical removal of the torn meniscus), at which time ACL surgery can significantly reduce the risk of developing arthritis compared to people who have only had a partial meniscectomy.


Knee ligament injuries such as ACL tears are serious injuries that cause pain and time away from normal activity.

Recovery requires surgery and long-term rehabilitation efforts but the long-term prognosis may not be good because most people develop arthritis within a decade of the injury.

A detailed and advanced discussion with your doctor and physical therapist can help you develop a multidisciplinary treatment plan that can help you prevent or reduce osteoarthritis and optimize long-term knee health.

Dr. Tanveer Bhutani at Eva Hospital is one of the best orthopedic surgeons in Ludhiana for ACL Reconstruction and he has helped many young people to recover from tears and after-effects.

About The Author

Tanveer Bhutani
Eva Hospital encompasses various modern orthopedic practices pioneered by the prominent orthopedic surgeon in Ludhiana “Dr. Tanveer Singh Bhutani”.

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