Loss of knee motion after ACL reconstruction leads to Osteoarthritis
Knee OA and ROM (written by Elizabeth Hofheinz @ OTW)
Say it with me…Range of Motion! A new study—recently presented at the annual meeting of the American Orthopaedic Society for Sports Medicine—is showing that the onset of osteoarthritis (OA) may be related to a loss of knee motion after reconstructive ACL surgery. The team found that patients who showed motion limitations after surgery were more likely to develop arthritic changes in the knee.
“Our research shows that patients given rehabilitation that emphasizes full motion be obtained and maintained throughout time after surgery have more favorable results on X-rays than patients who lose motion,” said lead researcher K. Donald Shelbourne, MD, founder, Shelbourne Knee Center in the July 9, 2011 news release.
The study examined data from 780 patients who were at least five years after ACL reconstruction with a patellar tendon graft. In individual follow-ups, patients were evaluated and rated based on knee range of motion tests and radiographs. The percentage of patients with normal radiographs (no arthritic changes in the knee) was 71% in patients with normal range of motion compared to 55% of patients who showed deficits in motion. In patients who had similar meniscus removal, OA was observed more in patients who had motion deficits.
“Something like osteoarthritis can be debilitating,” said Shelbourne, “and our goal is to continually find new ways to help patients avoid such a problem.”
Dr. Shelbourne told OTW,
The first thing clinicians need to do to is be able to recognize subtle differences in ROM between knees. ROM should be critically examined and the involved knee should be compared to the non-involved knee, to include an evaluation of knee hyperextension. Many clinicians consider ROM of zero degrees neutral to 135 degrees of flexion as normal. If the patient has 5 degrees of hyperextension and 145 degrees of flexion in the non-involved knee, then ROM in the involved knee of zero extension to 135 degrees of flexion means the patient has ROM loss that could increase their change of having osteoarthritis after surgery.