Woman experiencing pain from a torn ACL

One of the most common athletic injuries is the ACL tear, and this injury can lead to some serious long-term complications. Most notably, ACL injuries can lead to arthritis later in life even if effective treatment is pursued.

Research shows that people who undergo ACL reconstructive surgery are three to five times more likely to develop arthritis in the knee.1,2 However, there are things that ACL injury patients can do to reduce their arthritis risk.

Here is some information about the common athletic injury of an ACL tear and what can be done to prevent arthritis after ACL surgery. This article will cover what an ACL is, how it can become damaged, and why this damage can lead to ACL arthritis.

All About the ACL and ACL Tear

ACL stands for anterior cruciate ligament, and this is a major ligament in the knee.3 ACL tear injuries commonly occur in sports like basketball, volleyball, soccer, football, tennis, and gymnastics because these activities require jumping, sudden stops, and directional changes.

Individuals who suffer an ACL tear may feel and hear a pop in the knee, followed by swelling and severe pain. Loss of range of motion and feelings of instability are also common. Surgery is often recommended for athletes who have an ACL injury, and it can take six to nine months for athletes to fully get back to their favorite activities.

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Causes of ACL Arthritis

It is unfortunate but true that most young athletes who have ACL surgery in their teens will develop ACL arthritis by their 30s.4 This may be because an artificially reconstructed ACL rests at a slightly different angle than a natural one, and this changes the future positions and rotations of the knee. This fact has led some physicians to recommend non-surgical ACL injury treatments to young patients, such as injecting stem cells into damaged ligament fibers.5,6

The Frequency of Osteoarthritis after ACL Surgery

Osteoarthritis after ACL surgery occurs because reconstructed knees tend to be more prone to wear and tear of the protective cartilage on the ends of the bones.2 The first signs of osteoarthritis typically become noticeable about five to ten years after having this surgery.7 But of course, every ACL tear is different and other factors, such as repetitive knee injuries and weight gain, can also contribute to the early onset of osteoarthritis in athletes.

How to Prevent Arthritis After an ACL Injury

Fortunately, there are some preventative measures that can be taken during and after an ACL injury to prevent the onset of arthritis. Exercise therapy has proven very effective in reducing rates of OA in people who have had ACL surgery.7,8,9 Low-impact exercises are typically recommended for recovering ACL patients in order to reduce wear and tear to the knee.9 This could include swimming and upper body strength training to allow the injury to fully heal. Topical pain relief creams like JointFlex can help reduce discomfort while exercising without the risk of medication side effects.

To prevent an ACL injury from happening in the first place, regularly practice exercises that strengthen the hamstrings, hips, and lower abs.10,11 It is also a good idea to train and improve athletic techniques related to pivoting and jumping in particular, since these activities are common causes of ACL tears.

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1. Paschos, N. K. (2017 March). Anterior cruciate ligament reconstruction and knee osteoarthritis. World Journal of Orthopedics, 8, 212-217. Retrieved October 21, 2018 from National Center of Biotechnology Information https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359756/.
2. Doyle, K. (2014 March 27). Knee arthritis more likely after ACL surgery. Reuters. Retrieved October 21, 2018 from https://www.reuters.com/article/us-knee-arthritis-surgery/knee-arthritis-more-likely-after-acl-surgery-idUSBREA2Q1B120140327.
3. Anterior cruciate ligament (ACL). MedlinePlus. Retrieved October 21, 2018 https://medlineplus.gov/ency/article/001074.htm.
4. Porat, A. V., Roos, E. M., & Roos, H. (2004). High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiographic and patient relevant outcomes. Annals of the Rheumatic Diseases, 63, 269-273. BMJ Publishing Group. Retrieved October 21, 2018 from https://ard.bmj.com/content/63/3/269.
5. ACL injury: Does it require surgery? American Academy of Orthopaedic Surgeons. Retrieved October 21, 2018 from https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/.
6. Centeno, C. J., Pitts, J., Al-Sayegh, H., & Freeman, M.D. (2015 July). Anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow nucleated cells: a case series. Journal of Pain Research, 8, 437-447. Retrieved October 17, 2018 from National Center of Biotechnology Information https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527573/.
7. Davis, J. Adequate rehab after ACL repair Cuts OA risk. Arthritis Foundation. Retrieved October 21, 2018 from https://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/types/knee/acl-surgery-knee-range-motion.php.
8. ACL reconstruction – discharge. MedlinePlus. Retrieved October 21, 2018 from https://medlineplus.gov/ency/patientinstructions/000189.htm.
9. Quinn, E. & Fogoros, R. E. (2018 September 21). Step-By-Step Guide to ACL Rehabilitation Exercises. Verywellhealth. Retrieved October 21, 2018 from https://www.verywellhealth.com/acl-surgery-rehab-exercises-3120748.
10. Preventing ACL tears: 4 tips for girls and women. Johns Hopkins Medicine. Retrieved October 21, 2018 from https://www.hopkinsmedicine.org/health/healthy-woman/nutrition-fitness/preventing-acl-tears-4-tips-for-girls-and-women.
11. Camacho, R. How to prevent ACL injuries in high school athletes. Breakingmuscle.com. Retrieved October 21, 2018 from https://breakingmuscle.com/fitness/how-to-prevent-acl-injuries-in-high-school-athletes.