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· DOS Abstracts
Quantifying the risk of developing knee osteoarthritis
following knee injury - a systematic review and meta-
analysis
Erik Poulsen, Glaucia H. Goncalves, Ewa M. Roos, Jonas B. Thorlund, Carsten B. Juhl
Department of Sports Science and Clinical Biomechanics, University of Southern
Denmark; Department of Physical Therapy, Federal University of Sao Carlos, Brazil;
Department of Sports Science and Clinical Biomechanics, University of Southern
Denmark; Department of Sports Science and Clinical Biomechanics, University of
Southern Denmark; Department of Rehabilitation, Copenhagen University Hospital,
Herlev and Gentofte
Background:
Knee injury is reported as an osteoarthritis (OA) risk factor.
Purpose / Aim of Study:
To quantify the risk of knee OA following anterior cruci-
ate ligament (ACL) injury, meniscal injury or combined ACL and meniscus injury.
Materials and Methods:
Five major databases were searched up to April 1st
2015 and references from included studies and relevant systematic reviews were
screened. Two authors independently screened and assessed identified studies for
eligibility. Inclusion criteria: prospective or retrospective studies, ≥ 2-year follow-
up after knee injury, ≥ 18 years, un- injured contralateral knee or matched control
group for comparison, knee OA defined by radiographs or symptoms. Risk of bias
were assessed by the SIGN50 tool. Meta-analysis applied based on the logarith-
mic transformed Odds Ratio (OR) of developing knee osteoarthritis. Study hetero-
geneity were assessed by I-square statistics. Study registration: PROSPERO (ID:
CRD42015016900).
Findings / Results:
A total of 4559 papers were identified in the search, 261 full-
text were screened and 46 papers included. Knee OA diagnosis was based on ra-
diographs in 96% of studies. For ACL injury, 12 studies were included (185.276
participants, mean age 28.0, 35% females), OR for developing knee OA was 4.2
(95% CI: 2.4-7.6). Meniscal injury, 20 studies (6.211 participants, mean age 33.0,
23% females), OR 5.8 (95% CI: 3.9-8.6). Combined injury, 18 studies (1295 par-
ticipants, mean age 25.5, 32% females), OR 7.0 (95% CI: 4.8-10.4). Inconsistency
between study estimates for different injury types were between 57-91%. Risk of
bias assessment rated two studies of high quality, 43 acceptable, and one study
unacceptable.
Conclusions:
The risk of OA development following an ACL or a meniscal injury is
4 and 6 times higher compared to a non-injured knee. When sustaining a combined
injury, the risk is 7-fold.
No conflicts of interest reported
92.