hey everyone dr jeff peng here we've known for a while now that an acl injury to the knee increases
your risk of developing knee osteoarthritis in the future now we have better data to tell us
just how much increased risk there is i want to dive into two new articles recently published
in the american journal of sports medicine and if you've had an acl tear in the past you'll
definitely want to watch to the end because after hearing the data you're going to want to be more
proactive in treating your knees to prevent the development of knee arthritis let's dive right in
now if this is the first time you're watching one of my videos my goal is to help each and every one
of you live an active and healthy lifestyle so if that's something you're interested in please
consider subscribing to my channel acl tears are common sporting injuries and surgical treatment
with acl reconstructions have high success rates in getting people back to being physically active
but even with reconstructive surgery people who have had an acl injury have seven times the risk
of developing arthritis in the knee or requiring a knee replacement surgery this study followed 235
patients for 25 years after acl reconstructive surgery and they found that 60 of these people
had osteoarthritis in the knee that had the acl tear compared to only 18 in the other knee and
there are many possible explanations for this while surgeons try their best to restore the
full function of the acl there could still be persistent laxity in the knee continued
instability of the knee contributes to cartilage damage which leads to arthritis meniscus injuries
at the time of the acl tear also increases the risk of developing a degenerative knee now
unfortunately you can't change these outcomes but what you can change is what you do after an acl
injury there's a lot of data to suggest that many athletes and weekend warriors never return to full
strength in their injured knee and in my previous video i discussed how muscle weakness especially
involving the knee extensor mechanism increases the risk of developing arthritis by 30 percent by
keeping the affected leg nice and strong through a maintenance exercise program you can potentially
decrease your risk of developing arthritis now historically exercise therapy was the only risk
factor that you could change but now there may be something else researchers are actively looking at
how we can treat the micro environment of the knee after an acl injury can we alter the biochemistry
of the joint after an injury to decrease the future risk of developing arthritis here's what
we know so far we know there is a significant increase in inflammatory signaling cells in
the knee after an acl injury many of these inflammatory mediators and proteins can cause
damage to the cartilage and weaken the structures in the knee over the course of a month following
an acl injury these inflammatory markers slowly decrease while other important growth factors
slowly increase the release of all of these growth factors create an environment more conducive to
healing this may explain why many surgeons have noticed better surgical outcomes waiting about
one month after an acl injury to perform surgery and similar to how surgeons are analyzing the
inflammatory markers in the knee before and after injury sports medicine physicians are constantly
thinking about inflammatory markers well after surgery degenerative knees have significant
increases in inflammatory markers similar to right after an acl tear but unlike after an injury where
growth factors start to increase inflammatory markers stay persistently elevated in arthritis
so how can we address this how can we reset the biochemistry in a degenerative knee or a knee
at risk for degeneration well one potential way of doing this is by using prp injections
prp stands for platelet-rich plasma they contain an incredible amount of growth
factors that can change the micro environment of an injured knee to keep it neutral and hopefully
prevent the development of arthritis many sports medicine physicians are recommending a prp
injection after an acl surgery to keep the micro environment of the knee as healthy as possible
others are also recommending prp injections well after surgery for maintenance therapy
this is an exciting area of research and hopefully we can use prp to help prevent post-traumatic knee
arthritis now if you already have signs of knee osteoarthritis then you'll definitely want to
check out this video where i discuss all forms of non-surgical treatment options thanks for watching