Michelle C. Walaszek

Context: Early identification of knee osteoarthritis (OA) symptoms after anterior cruciate ligament reconstruction (ACLR) could enable timely interventions to improve long-term outcomes. However, little is known about the change in early OA symptoms from 6 to 12 months post-ACLR. Objective: To evaluate the change over time in meeting classification criteria for early knee OA symptoms from 6 to 12 months after ACLR. Design: Prospective cohort study. Setting: Research laboratory. Patients or Other Participants: Eighty-two participants aged 13 to 35 years who underwent unilateral primary ACLR. On average, participants’ first and second visits were 6.2 and 12.1 months post-ACLR. Main Outcome Measure(s): Early OA symptoms were classified using generic (Luyten Original) and patient population–specific (Luyten Patient Acceptable Symptom State [PASS]) thresholds on Knee injury and Osteoarthritis Outcome Score (KOOS) subscales. Changes in meeting early OA criteria were compared between an initial and follow-up visit at an average of 6 and 12 months post-ACLR, respectively. Results: Twenty-two percent of participants exhibited persistent early OA symptoms across both visits using both the Luyten Original and PASS criteria. From initial to follow-up visit, 18% to 27% had resolution of early OA symptoms, while 4% to 9% developed incident symptoms. In total, 48% to 51% had no early OA symptoms at either visit. No differences were found for change in early OA status between adults and adolescents. Conclusions: Nearly one-quarter of participants exhibited persistent early knee OA symptoms based on KOOS thresholds from 6 to 12 months post-ACLR. Determining if this symptom persistence predicts worse long-term outcomes could inform the need for timely interventions after ACLR. Future researchers should examine if resolving persistent symptoms in this critical window improves later outcomes. Tracking early OA symptoms over time may identify high-risk patients who could benefit from early treatment.

Visuomotor reaction time (VMRT) is predictive of lower-extremity musculoskeletal injury and may be a modifiable anterior cruciate ligament (ACL) injury risk factor that affects the incidence of primary and secondary ACL injuries in females. However, it is unknown if females with ACL reconstruction (ACLR) experience diminished VMRT compared with their male counterparts. The purpose of this study was to compare lower-extremity VMRT (LEVMRT) between males and females with ACLR. Female (n = 40) and male (n = 20) participants who were between 4 and 12 months after primary, unilateral ACLR completed a LEVMRT task with each limb using a series of wireless light discs. Mann–Whitney U tests were used to compare between-group differences for LEVMRT (in milliseconds). No statistically significant sex differences were observed for LEVMRT when the ACLR limb deactivated the light discs (females = 509.5 [132.5], males = 507.0 [79.8]; p = .77) or when the ACLR limb was stabilizing while the nonsurgical limb deactivated the light discs (females = 528.5 [105.3], males = 546.0 [92.5]; p = .77). Both males and females may benefit from visual motor training to improve VMRT after ACLR.