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Reading 2 mins.
in collaboration with
Dr Laurent Grange (Rheumatologist)
Medical validation:
February 12, 2023
Rupture of the anterior cruciate ligaments is common among athletes or during skiing accidents. After surgery, the risk of knee osteoarthritis is multiplied by 8 within 11 years. How to reduce this risk? A new study offers several leads.
While deterioration of the knee joint is common after anterior cruciate ligament surgery, little is known about it. In an attempt to understand the causal link, researchers have analyzed the risk of knee osteoarthritis in people who have undergone this surgery.
People who have experienced cruciate ligament rupture have an 8.2-fold increased risk of knee osteoarthritis within 11 years of surgery, compared to those who have not experienced such events.
What are the factors that will promote the development of osteoarthritis? What are the effects of the rupture of coirsed ligaments well beyond surgery and the rehabilitation period? What can be done to reduce this risk? To answer these questions, Yale Medicine scientists recruited and observed 46 adult patients (male and female) who underwent anterior cruciate ligament (ACL) surgery.
They then measured the impact of joint load (i.e. the pressure exerted on the joint) on the risk of osteoarthritis of the patellar femoral joint after surgery.
To do this, they evaluated the kinematics of the trunk and lower limbs (allowing to assess the impact of a pathology at a very specific joint level), but also the impact on the ground of each participant during jumps.
All these data made it possible to calculate the amount of contact force exerted on the joint. The research team then performed joint MRIs of the knees of 32 participants, five years after undergoing the operation.
Demand his articulation neither too much nor too little…
The team found that candidates who put less pressure on their joint while jumping were more likely to have osteoarthritis one year after surgery, as well as worsening osteoarthritis up to 5 years after surgery. surgery.
Conversely, they also found that the heaviest and tallest participants – mainly men – were at higher risk of osteoarthritis. Because a greater weight leads to a greater contact force, which could promote joint damage.
For one thing, a reduced joint load could lead to cartilage breakdown, making the joint susceptible to long-term damage and degeneration. On the other hand, excessive weight would mechanically favor a more rapid progression of declared osteoarthritis.
The challenge would thus be to define an optimal load (neither too low nor too high) to reduce the risk of osteoarthritis.
Interesting observations but too little provided, according to Dr. Grange.
“Obesity is a risk factor for osteoarthritis and this study confirms it. Concerning the patients who undergo less articular pressure and who are more at risk of osteoarthritis, one can imagine that this phenomenon is explained by the less movement carried out on the cartilage, then less “nourished” by the cytokines. But it would take more research on this subject to explain it. What is certain is that this work has many limitations: few patients were observed, all do not seem equal in terms of the risk of osteoarthritis and the results cannot be put into practice. If they are confirmed, it will be necessary to measure the pressures on the joint indirectly in order to find out more“, concludes the expert.
Even after cruciate ligament surgery, the rheumatologist also recommends “keep a leisure and regular physical activity in order to keep a toned bodybuilding”. The ideal? “Distribute your sports sessions well, which must be regular and progressive.”