Adolescents and young adults who undertake sports are at a higher risk of traumatic knee injuries such as ACL (Anterior Cruciate Ligament) and meniscal tears. This population is significantly more likely to suffer Post Traumatic Knee Osteoarthritis (PTOA). The rate of joint replacement and arthroplasty in this group is 6 times more than in the general population.
A consensus group comprising of 36 expert physios, physicians, and scientists as well as patients with previous knee injuries from 9 different countries formed to look at the research data on PTOA. The aim of the group was to look at:
- WHO to target to prevent post traumatic knee OA.
- WHAT and WHEN to target to prevent post traumatic knee OA.
- WHAT to do after ACL tear.
- WHAT to monitor after knee injury.
- HOW to monitor.
- Patient reported outcomes after knee injury.
- Muscle function after knee injury.
- Functional performance after knee injury.
- INTERPRETING patient reported outcomes, muscle function and functional performance.
The reviews included over 230 studies and data from 130,000 individuals with traumatic knee injuries, with a focus on ACL and meniscal tears. From reviews of the data compiled, the group came up with the eight clinical recommendations tabled below.
One of the main recommendations from the group was a change in thinking regarding management of ACL tears, which have previously been managed quite aggressively with surgery in Australia and around the world. The group advocated delaying surgery on ACL injuries until the knee had settled and patients had managed to undertake appropriate conservative rehabilitation without achieving what they felt was an appropriate level of function in the knee.
Article by Jim Burke
