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Long-term impact of acute knee injury with hemarthrosis : Osteoarthritis incidence and patient-reported outcomes in a large consecutive cohort over 12 years

Isacsson, Anders LU orcid ; Turkiewicz, Aleksandra LU ; Olsson, Ola ; Brown, Jamie S. LU orcid ; Hesslow, Johan ; Bengtsson, Patrik ; Mahmoudian, Armaghan LU ; Frobell, Richard B. LU ; Paemre, Jaanika and Englund, Martin LU orcid (2025) In Osteoarthritis and Cartilage Open 7(4).
Abstract

Objective: To estimate the 12-year risk of radiographic and/or symptomatic knee osteoarthritis following different MRI-confirmed soft-tissue knee injuries. Design: Prospective cohort study including 814 (70 ​%) of 1129 consecutive patients after acute knee trauma with hemarthrosis in a single hospital. Injuries were classified by sub-acute knee MRI. Follow-up comprised bilateral knee radiography and Knee injury and Osteoarthritis Outcome Score. The main outcomes were radiographic and symptomatic knee osteoarthritis. We estimated differences between injury types and injured versus contralateral knees. Results: The incidence proportion of radiographic knee osteoarthritis was 34 ​% (95 ​% confidence interval 30 to 37) in injured knees and... (More)

Objective: To estimate the 12-year risk of radiographic and/or symptomatic knee osteoarthritis following different MRI-confirmed soft-tissue knee injuries. Design: Prospective cohort study including 814 (70 ​%) of 1129 consecutive patients after acute knee trauma with hemarthrosis in a single hospital. Injuries were classified by sub-acute knee MRI. Follow-up comprised bilateral knee radiography and Knee injury and Osteoarthritis Outcome Score. The main outcomes were radiographic and symptomatic knee osteoarthritis. We estimated differences between injury types and injured versus contralateral knees. Results: The incidence proportion of radiographic knee osteoarthritis was 34 ​% (95 ​% confidence interval 30 to 37) in injured knees and 18 ​% (15, 20) in contralateral knees. Knees with hemarthrosis but no structural injury developed radiographic osteoarthritis and symptomatic osteoarthritis in 6 ​% and 4 ​%, respectively, as compared to 36 ​% and 21 ​% of those with structural injury, with risk ratios (95 ​% confidence interval) of 8 (3, 21) for radiographic osteoarthritis and 6 (2, 20) for symptomatic osteoarthritis. The risk ratio of tibiofemoral osteoarthritis in the injured knee compared to the contralateral knee was 2.2 (1.7, 2.8), with the highest ratio of 3.1 (2.1, 4.6) observed after combined anterior cruciate ligament (ACL) and meniscus injury. Overall, 81 ​% (78, 84) reported satisfaction with their knee function, though satisfaction was lower following patellar dislocation. Conclusions: Structural soft-tissue knee injury doubled the risk of radiographic and symptomatic knee osteoarthritis versus the contralateral knee over 12 years with significant variation based on injury type. ACL rupture combined with meniscus tear conferred the highest risk while hemarthrosis alone the lowest.

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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anterior cruciate ligament, Hemarthrosis, Knee, Osteoarthritis, Outcome, Soft-tissue knee injury
in
Osteoarthritis and Cartilage Open
volume
7
issue
4
article number
100700
publisher
Elsevier
external identifiers
  • scopus:105020779332
ISSN
2665-9131
DOI
10.1016/j.ocarto.2025.100700
language
English
LU publication?
yes
id
138e29ae-0e86-44cb-97d6-6615feaa60bb
date added to LUP
2025-12-09 14:37:38
date last changed
2025-12-09 14:38:56
@article{138e29ae-0e86-44cb-97d6-6615feaa60bb,
  abstract     = {{<p>Objective: To estimate the 12-year risk of radiographic and/or symptomatic knee osteoarthritis following different MRI-confirmed soft-tissue knee injuries. Design: Prospective cohort study including 814 (70 ​%) of 1129 consecutive patients after acute knee trauma with hemarthrosis in a single hospital. Injuries were classified by sub-acute knee MRI. Follow-up comprised bilateral knee radiography and Knee injury and Osteoarthritis Outcome Score. The main outcomes were radiographic and symptomatic knee osteoarthritis. We estimated differences between injury types and injured versus contralateral knees. Results: The incidence proportion of radiographic knee osteoarthritis was 34 ​% (95 ​% confidence interval 30 to 37) in injured knees and 18 ​% (15, 20) in contralateral knees. Knees with hemarthrosis but no structural injury developed radiographic osteoarthritis and symptomatic osteoarthritis in 6 ​% and 4 ​%, respectively, as compared to 36 ​% and 21 ​% of those with structural injury, with risk ratios (95 ​% confidence interval) of 8 (3, 21) for radiographic osteoarthritis and 6 (2, 20) for symptomatic osteoarthritis. The risk ratio of tibiofemoral osteoarthritis in the injured knee compared to the contralateral knee was 2.2 (1.7, 2.8), with the highest ratio of 3.1 (2.1, 4.6) observed after combined anterior cruciate ligament (ACL) and meniscus injury. Overall, 81 ​% (78, 84) reported satisfaction with their knee function, though satisfaction was lower following patellar dislocation. Conclusions: Structural soft-tissue knee injury doubled the risk of radiographic and symptomatic knee osteoarthritis versus the contralateral knee over 12 years with significant variation based on injury type. ACL rupture combined with meniscus tear conferred the highest risk while hemarthrosis alone the lowest.</p>}},
  author       = {{Isacsson, Anders and Turkiewicz, Aleksandra and Olsson, Ola and Brown, Jamie S. and Hesslow, Johan and Bengtsson, Patrik and Mahmoudian, Armaghan and Frobell, Richard B. and Paemre, Jaanika and Englund, Martin}},
  issn         = {{2665-9131}},
  keywords     = {{Anterior cruciate ligament; Hemarthrosis; Knee; Osteoarthritis; Outcome; Soft-tissue knee injury}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage Open}},
  title        = {{Long-term impact of acute knee injury with hemarthrosis : Osteoarthritis incidence and patient-reported outcomes in a large consecutive cohort over 12 years}},
  url          = {{http://dx.doi.org/10.1016/j.ocarto.2025.100700}},
  doi          = {{10.1016/j.ocarto.2025.100700}},
  volume       = {{7}},
  year         = {{2025}},
}