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Journal article
Long-term impact of acute knee injury with hemarthrosis: Osteoarthritis incidence and patient-reported outcomes in a large consecutive cohort over 12 years
Osteoarthritis and cartilage open, Vol.7(4), 100700
11/2025
PMID: 41367622
Web of Science ID: WOS:001614963500001
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Abstract
Objective
To estimate the 12-year risk of radiographic and/or symptomatic knee osteoarthritis following different MRI-confirmed soft-tissue knee injuries.
Design
Prospective cohort study including 814 (70 %) of 1129 consecutive patients after acute knee trauma with hemarthrosis in a single hospital. Injuries were classified by sub-acute knee MRI. Follow-up comprised bilateral knee radiography and Knee injury and Osteoarthritis Outcome Score. The main outcomes were radiographic and symptomatic knee osteoarthritis. We estimated differences between injury types and injured versus contralateral knees.
Results
The incidence proportion of radiographic knee osteoarthritis was 34 % (95 % confidence interval 30 to 37) in injured knees and 18 % (15, 20) in contralateral knees. Knees with hemarthrosis but no structural injury developed radiographic osteoarthritis and symptomatic osteoarthritis in 6 % and 4 %, respectively, as compared to 36 % and 21 % of those with structural injury, with risk ratios (95 % confidence interval) of 8 (3, 21) for radiographic osteoarthritis and 6 (2, 20) for symptomatic osteoarthritis. The risk ratio of tibiofemoral osteoarthritis in the injured knee compared to the contralateral knee was 2.2 (1.7, 2.8), with the highest ratio of 3.1 (2.1, 4.6) observed after combined anterior cruciate ligament (ACL) and meniscus injury. Overall, 81 % (78, 84) reported satisfaction with their knee function, though satisfaction was lower following patellar dislocation.
Conclusions
Structural soft-tissue knee injury doubled the risk of radiographic and symptomatic knee osteoarthritis versus the contralateral knee over 12 years with significant variation based on injury type. ACL rupture combined with meniscus tear conferred the highest risk while hemarthrosis alone the lowest.
Details
- Title
- Long-term impact of acute knee injury with hemarthrosis
- Publication Details
- Osteoarthritis and cartilage open, Vol.7(4), 100700
- Resource Type
- Journal article
- Publisher
- Published by Elsevier Ltd on behalf of Osteoarthritis Research Society International (OARSI)
- Number of pages
- 8
- Grant note
- Stig and Ragna Gorthon Foundation, Helsingborg, SwedenSwedish Research CouncilOsterlund FoundationGustaf V 80-Year Birthday FoundationGreta and Johan Kock FoundationGovernmental Funding of Clinical Research within National Health Service (ALF)Swedish Rheumatism AssociationFoundation for People with Movement Disability in Skane
This study has been funded by the Stig and Ragna Gorthon Foundation, Helsingborg, Sweden, The Swedish Research Council, Osterlund Foundation, Gustaf V 80-Year Birthday Foundation, Greta and Johan Kock Foundation, Governmental Funding of Clinical Research within National Health Service (ALF) , the Swedish Rheumatism Association, and the Foundation for People with Movement Disability in Skane. None of the funding sources had any involvement in this study, from conception to manuscript.
- Copyright
- © 2025 The Author(s)
- Identifiers
- WOS:001614963500001; 99381535288406600
- Academic Unit
- Usha Kundu, MD College of Health; Movement Sciences and Health
- Language
- English