ACL injury in at-risk osteoarthritis patients associated with joint space loss

Patients with anterior cruciate ligament (ACL) mucoid degeneration at MRI who are also at-risk for osteoarthritis (OA) are associated with progression of joint space loss in the primary weight-bearing area of the knee, according to research published online Feb. 21 in Radiology.

The study evaluated the baseline demographic, clinical, radiographic and MR imaging osteoarthritis knee score (MOAKS) data of 600 participants from the Osteoarthritis Initiative database.

“Despite the established association between ACL rupture and knee OA progression, to our knowledge, the association of ACL mucoid with development or worsening of OA is unknown,” wrote corresponding author Shadpour Demehri, MD, an assistant professor in the Johns Hopkins Medicine Department of Radiology and Radiological Science, and colleagues.

Knees with ACL mucoid degeneration demonstrated a greater proportion of joint space loss (JSL) progression, more severe baseline radiographic OA features and more medial tibiofemoral compartment (MTFC) JSL progression compared to knees with a normal ACL.

Similarly, participants with ACL mucoid degeneration had more subregions with at least one focal abnormality in the assessment of cartilage surface area than their normal ACL counterparts. The ACL injury was also associated with up to 48-month progression of MTFC JSL in participants with less baseline cartilage surface area damage by using the MRI–based MOAKS determination.

“ACL mucoid degeneration at MR imaging in participants with or at risk for OA is associated with progression of MTFC JSL at radiography, especially in knees with less baseline cartilage surface area damage,” wrote Demehri et al.