The term “arthritis” is used a lot to make people believe they have a chance of developing a debilitating condition after ACL surgery. It’s a word that makes people feel like they aren’t necessarily in control of their recovery process or their long-term health.
The truth is that arthritis isn’t as “big and scary” as it may seem – even if you’ve been diagnosed with arthritis after ACL surgery, you can still make a full recovery. The information in this article was written to empower you and let you know that you ultimately are still in control of your long term health.
Arthritis means “inflammation of a joint.” After ACL surgery, the most common form of arthritis developed is “osteoarthritis,” which means that the cartilage in the knee has started to degenerate. It is often associated with pain, stiffness, and functional impairment.
Around 50% of patients develop arthritis within 12-14 years after ACL surgery. This is the data often presented to those undergoing ACL surgery, and it can feel like it’s just a “shot in the dark” whether or not you end up with arthritis after ACL surgery. That’s not the case.
Now that we’ve got the easy stuff on arthritis out of the way, let’s focus on the positives. Arthritis after ACL surgery doesn’t have to be debilitating. One study found that up to 43% of adults >40 years old have MRIs that suggest osteoarthritis is present, but have NO symptoms.
What’s this mean? It means that the conditions of arthritis can be present in your knee, but YOU can be asymptomatic. The knee can still be mobile and pain free. It means that being diagnosed with arthritis isn’t necessarily a long term condition. It means that you can eventually return to do the things you enjoy doing without worrying about the knee. It means that YOU are back in control of whether or not arthritis is something that holds you back after ACL surgery.
A research group in 2016 was interested by the data above, and decided to conduct a study on the biomechanical (the way you move) differences between people with symptomatic (painful, stiff) arthritis and asymptomatic (no pain, no stiffness) arthritis. They found that the biomechanics and muscle activation in those who were symptomatic were clearly different than those who were asymptomatic.
Biomechanics (movement patterns) and muscle activation are two things that you can control. You can work to change your movement patterns and improve muscle activation. Therefore, you can work to prevent the onset of arthritis AND reverse the symptoms of arthritis (if you’re already struggling with it).
To gain a better understanding of compensation patterns, you can check out this post: What Are Compensation Patterns And Why Do They Matter For ACL Recovery?
The last couple of sections have included a lot of technical jargon, so this is my attempt to make the concepts a bit simpler. In the first section, we hit on the idea that osteoarthritis is normally indicated by some form of degeneration of the cartilage. It’s this definition that makes people think it is a permanent, painful condition.
However, I encourage you to think of cartilage as one of the LAST lines of defense for protecting a joint. The FIRST line of defense is the muscles – they are designed to create and absorb force around the joints. If you can get the first line of defense working optimally, stress on the knee will decrease, and the degeneration in the last line of defense (the cartilage) won’t be so important.
For a simple exercise that can be performed anywhere to get muscles functioning properly, check out this post: Mastering The Isometric Squat After ACL Surgery
Hopefully, the information presented in this post has helped you to feel empowered a bit more when thinking about the onset of arthritis after ACL surgery. If you can get the muscles firing optimally by working on your movement patterns and muscle activation patterns, you can put yourself in a position to minimize the risks of painful arthritis.
As we tell all of our Accelerate ACL athletes, if you have any questions, always, always, always, feel to reach out.
Shoot us an email a firstname.lastname@example.org and we will get back to you as soon as possible.
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- Astephen Wilson JL, Stanish WD, Hubley-Kozey CL. Asymptomatic and symptomatic individuals with the same radiographic evidence of knee osteoarthritis walk with different knee moments and muscle activity. J Orthop Res. 2017 Aug;35(8):1661-1670. doi: 10.1002/jor.23465. Epub 2016 Nov 1. PMID: 27775183.
- Culvenor AG, Øiestad BE, Hart HF, et al. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. British Journal of Sports Medicine 2019;53:1268-1278.
- Cheung EC, DiLallo M, Feeley BT, Lansdown DA. Osteoarthritis and ACL Reconstruction-Myths and Risks. Curr Rev Musculoskelet Med. 2020;13(1):115-122. doi:10.1007/s12178-019-09596-w