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Collagen breakdown after ACL injury may point to more severe osteoarthritis later

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Many patients who have surgery to repair the Anterior Cruciate Ligament (ACL) go on to develop post-traumatic osteoarthritis (PTOA) later in life, but new research shows that higher levels of collagen breakdown after ACL injury may identify those patients who will go on to develop more severe PTOA.

A study presented at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day in San Diego showed how a particular set of biomarkers on the day of surgery may explain why some individuals have worse PTOA than others after two years.

“Previous studies demonstrated how ACL injury triggers a biochemical process that worsens after the first 4-6 weeks of injury,” said lead author Dr Christian Lattermann from the University of Kentucky. “Our research notes that higher levels of collagen breakdown at the time of surgery may correlate to worse outcomes at two years.”

Dr Lattermann and colleagues studied 18 patients (nine male and nine female, aged 14-32 years) with an ACL injury. The participants were previously enrolled in a prospective randomised trial evaluating early anti-inflammatory treatment after ACL injury. As part of the initial trial, synovial, serum and urinary biomarkers of chondrodegeneration and inflammation were collected on the day of the surgery.

“Our data strongly suggests that initial biochemical changes after injury may have powerful consequences that cannot be mitigated by surgical stabilisation alone,” Dr Lattermann explained. “These results also create an opportunity to learn more about how early interventions with anti-inflammatory medications may help lessen osteoarthritis risks in ACL patients, especially those patients with high levels of a particular biomarker.”