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The association between radiographic knee osteoarthritis and knee symptoms, function and quality of life 10–15 years after anterior cruciate ligament reconstruction
  1. B E Øiestad1,
  2. I Holm2,4,
  3. L Engebretsen3,4,
  4. M A Risberg1,3
  1. 1Department of Orthopaedics, Norwegian research centre for Active Rehabilitation (NAR), Oslo University Hospital, Oslo, Norway
  2. 2Department of Rehabilitation, Oslo University Hospital Rikshospitalet and University of Oslo, Oslo, Norway
  3. 3Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  4. 4Department of Medicine, University of Oslo, Oslo, Norway
  1. Correspondence to Mrs B E Øiestad, Hjelp 24 NIMI Ullevaal, Pb. 3843, Ullevål stadion, 0805 Oslo, Norway; oiestad{at}


Background There are conflicting results in the literature regarding the association between radiographic knee osteoarthritis (OA) and symptoms and function in subjects with previous anterior cruciate ligament (ACL) reconstruction.

Aim To investigate the associations between radiographic tibiofemoral knee OA and knee pain, symptoms, function and knee-related quality of life (QOL) 10–15 years after ACL reconstruction.

Study design Cross-sectional study.

Material and methods 258 subjects were consecutively included at the time of ACL reconstruction and followed up prospectively. The authors included the Knee Injury and Osteoarthritis Outcome Score to evaluate knee pain, other symptoms (symptoms), activities of daily living and sport and recreation (Sport/Rec) and QOL. The subjects underwent standing radiographs 10–15 years after the ACL reconstruction. The radiographs were graded with the Kellgren and Lawrence (K&L) classification (grade 0–4).

Results 210 subjects (81%) consented to participate in the 10–15-year follow-up. Radiographic knee OA (K&L ≥grade 2) was detected in 71%, and 24% showed moderate or severe radiographic knee OA (K&L grades 3 and 4). No significant associations were detected between radiographic knee OA (K&L grade ≥2) and pain, function or QOL, respectively, but subjects with radiographic knee OA showed significantly increased symptoms. Severe radiographic knee OA (K&L grade 4) was significantly associated with more pain, symptoms, impaired Sport/Rec and reduced QOL.

Conclusion Subjects with radiographic knee OA showed significantly more symptoms than those without OA, and subjects with severe radiographic knee OA had significantly more pain, impaired function and reduced quality of life than those without radiographic knee OA 10–15 years after ACL reconstruction.

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  • Competing interests None.

  • Funding This study was funded by the South-Eastern Regional Health Authority in Norway through the Osteoarthritis Research Group.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by Regional Committees for Medical and Health Research Ethics in Norway.

  • Provenance and peer review Not commissioned; externally peer reviewed.