An excellent new evidence shows a higher osteoarthritis risk after ACL graft rupture 30 years after ACL reconstruction compared to those with intact ACL grafts. So, intact ACL graft reduces the risk for increased OA development (Knee Surgery, Sports Traumatology, Arthroscopy volume 28, pages 2139–2146 (2020).
This study data indicates, that in a period of median 31 (range 28–33) years after ACL reconstruction, 50% of the patients showed an intact ACL graft and no side-to-side difference regarding anterior knee laxity. But, if ACL grafts were ruptured, patients had more osteoarthritis in the medial tibiofemoral compartment than those with intact ACL grafts. No more doubt – knee has to be stable to avoid early osteoarthritis, also, successful ACL reconstruction technique is most important, and if rupture of the ACL graft happens, revision ACL reconstruction should be performed to make knee stable and prevent osteoarthritis in the future. Excellent results can be achieved with regard to functional knee stability after revision ALC reconstruction even in early osteoarthritic knees.