Alarming is the word Von Parat, Roos, and Roos choose to describe their findings of significant knee osteoarthritis in middle aged former soccer players who had sustained a rupture of the anterior cruciate ligament more than a decade previously.¹ Not only was there a high incidence of osteoarthritis in these former players, but reconstruction of the anterior cruciate ligament did not appear to provide protection from degenerative change in the knee.

In a 14 year follow up of subjects who had formed the basis of an earlier study,² the authors identified 238 male soccer players who were diagnosed with anterior cruciate ligament injuries in 1986. They were able to contact 205 of the players. Of these, 154 answered questionnaires and a further subgroup of 122 consented to have knee radiographs.

In just over half of the 95 subjects with radiographic changes, there was osteoarthritis equivalent to Kellgren-Lawrence grade 2 or higher. Of the subjects who answered questionnaires, 58% had undergone anterior cruciate ligament reconstruction. Interestingly, and perhaps surprisingly, there was no difference in radiographic outcome between those that had been treated with anterior cruciate ligament reconstruction and those who had not undergone reconstructive surgery. On the other hand, subjects who had sustained a meniscal tear had an increased prevalence of osteoarthritis, but the severity of radiographic changes was similar to those who did not have meniscal pathology associated with their anterior cruciate ligament rupture. …