Association of Quadriceps Strength Symmetry and Surgical Status With Clinical Osteoarthritis Five Years After Anterior Cruciate Ligament Rupture

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Abstract
Objective: The objective of this study was to examine the association of quadriceps strength symmetry and surgical status (anterior cruciate ligament [ACL] reconstruction or nonoperative management) with early clinical knee osteoarthritis (OA) 5 years after ACL injury or reconstruction.Methods: In total, 204 of 300 athletes were analyzed 5 years after ACL injury or reconstruction. Quadriceps strength was measured and reported as a limb symmetry index. We identified participants with early clinical knee OA using the criteria that 2 of 4 Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales score ≤85%. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression and adjusted for age, sex, meniscal injury, and body mass index to examine the associations of quadriceps strength and surgical status with clinical knee OA.Results: In all, 21% of participants met the KOOS criteria for clinical knee OA. For every 1% increase in quadriceps limb symmetry index, there was a 4% lower odds of clinical OA (adjusted OR [ORadj] 0.96 [95% CI 0.93–0.99]) at 5 years. Surgical status was not associated with clinical knee OA (ORadj 0.58 [95% CI 0.23–1.50]).Conclusion: More symmetric quadriceps strength, but not surgical status, 5 years after ACL injury or reconstruction was associated with lower odds of clinical knee OA.
Funding Information
  • National Institutes of Health (F32‐AR‐073090, R37‐HD‐037985)

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