Knowledge and Beliefs About Knee Osteoarthritis After Anterior Cruciate
Ligament Injury and Reconstruction

KL, Ginckel AV, Kean CO, Nelligan RK, French SD, Stokes M, Pietrosimone B,
Blackburn T, Batt M, Hunter DJ, Spiers L, & Hinman RS.  Arthritis
Care Res
. 2016;68:1180-1185. doi: 10.1002/acr.22794

Take Home Message: Patients who suffered a knee injury have
some understanding of their long-term risks. 
However, there is an astoundingly low number of patients who recall
having conversations with health care professionals about the long-term risks
after an injury. 

We have an earlier post on Sports Med Res about athletic trainers’ knowledge and perceptions of
osteoarthritis (OA) after a knee injury. 
While it is important for sports medicine clinicians to be aware about
OA, it is even more important that this information is communicated to patients
who suffer a knee injury.  Therefore, the
authors of this research study wanted to assess the knowledge of patients who
had suffered a knee injury about OA, and whether these individuals had
conversations with their health professional about their OA risks.  The researchers gave a survey to patients who
suffered an anterior cruciate ligament (ACL) injury between 1 to 5 years before
the survey. Overall, 233 adults completed the survey in Australia and United
States. The survey had three parts: 1) personal characteristics, 2) knowledge
about OA and OA risk, and 3) health professional advice. Approximately half of
the participants were able to correctly identify the definition of OA and
believed that they were at a greater risk for developing OA after their knee
injury. Most adults (> 73%) agreed that having an ACL injury or meniscal
tear increases the risk of knee OA. Over 80% of adults agreed that having knee
OA would be a major health concern and within this sample, Australian adults
(36%) were more likely than American adults (7%) to strongly agree that having
knee OA would be a major health concern. 
However, about 30% believed that undergoing an ACL reconstruction
surgery would decrease their risk of developing OA.  Finally, only 27% recalled having a
conversation with their health professional about OA risks associated with
their knee injury.      

This research study is interesting
because the knowledge that health care professionals does not appear to be
making an impact on patient care.  Astoundingly,
only 27% of the participants recalled a conversation regarding OA and long-term
management after their knee injury.  A
majority of this advice came from an orthopedic surgeon; however, some advice
also came from a physiotherapist or other health care professional.  Sports medicine clinicians tend to see these
patients regularly, and it is important that we make lasting impressions about long-term
joint health.  Briefly “mentioning” an
increased risk does not make an impact with patients.  We need to emphasize the importance of
long-term well-being and help to provide strategies for long-term
management.  Similar to a classroom, we
need to make sure that we — the educated health professionals — help our
patients/students learn the importance of this problem.  It is important that a patient understand
their risks after a knee injury so that they can make good decisions regarding
their long-term joint health. 
Unfortunately, there are still a good number of patients who believe
that getting surgery will decrease their chances of having long-term problems.
As clinicians, we should help to educate our patients so that they can
understand why they are doing certain things with treatment or
rehabilitation.  Interesting, the authors
also found that Australians were more likely to strongly agree that OA was a
major health problem in comparison to the American patients.  This study shows us that we need to be more
proactive as health care professionals in getting through to our patients about
long-term risks of OA following knee injury. 
This is a widely accepted risk and the importance of long-term
management needs to be presented in a way to make a difference to our

for Discussion:  What do you think is the
best way to make an impression about long-term risks to a patient who has
suffered a knee injury?  What information
do you share with patients after they have suffered a knee injury?

by: Nicole Cattano
by: Jeffrey Driban


Bennell, K., van Ginckel, A., Kean, C., Nelligan, R., French, S., Stokes, M., Pietrosimone, B., Blackburn, T., Batt, M., Hunter, D., Spiers, L., & Hinman, R. (2016). Patient Knowledge and Beliefs About Knee Osteoarthritis After Anterior Cruciate Ligament Injury and Reconstruction Arthritis Care & Research, 68 (8), 1180-1185 DOI: 10.1002/acr.22794