Knee complaints and prognosis of osteoarthritis at 10 years : impact of ACL ruptures, meniscal tears, genetic predisposition and surgery

Abstract

In this thesis we demonstrated that several known risk factors for knee OA development i.e. ACL ruptures, meniscal tears, the presence of hand OA and increased BMI, are already associated with knee OA development as demonstrated on radiographs and MR images early in life. Identifying these factors in young to middle aged patients suffering from knee complaints helps to define high risk patients who may benefit from early preventive exercise therapy or maybe disease modifying drugs which might be developed in the future. Meniscectomy and ACL reconstruction have no effect on knee OA development after 10 years in patients with sub-acute knee complaints. The in this thesis validated automatic JSW quantification method is sensitive to small changes in JSW of the finger joints. The first signs of hand OA development with this method can be detected within one or two years. In patients with traumatic meniscal tears but without knee locking symptoms, there may be some benefits from treatment with meniscectomy in long-term Sports and Recreation knee function outcomes compared to conservative treatment. Future randomized controlled trials may elucidate the effect of surgical treatment of traumatic meniscal tears.