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August 7, 2006

A University of Michigan Health Minute update on important health issues.

U-M expert: Common childhood sports injury can lead to early onset of arthritis

U-M to study ACL injuries among youth and how they relate to the onset of arthritis

ANN ARBOR, MI – Seventeen-year-old Claire Anthony lives for sports. Her list of activities includes skiing, basketball, hockey, track and volleyball. But a tear to her anterior cruciate ligament, or ACL, while playing basketball at the age of 14, and one to her other knee two years later during a volleyball game, has slowed her active lifestyle.


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But athletes like Anthony who injure their ACL – one of the four major ligaments in the knee – have more to worry about than the long road to recovery and being sidelined for months at a time.

Nearly 70 percent of ACL injuries in these young athletes will lead to an early onset of osteoarthritis, a degenerative arthritis that causes the breakdown of the cartilage in joints that only worsens over time.

“I have a lot of concerns about what’s going to happen when I’m older.” says Anthony. “I’ve been told that I will get arthritis very soon in life, and there could be more knee surgeries in the future that would prevent me from playing college sports.”

But a new study at the University of Michigan is looking to offer these young athletes hope and relief from degenerative arthritis.

Led by Riann Palmieri, Ph.D., assistant professor in the U-M Division of Kinesiology, and Edward Wojtys, M.D., medical director of MedSport Sports Medicine Program at UMHS, the study will work to identify the earliest signs of degenerative arthritis in young knees, to allow for early medical intervention that would prevent the progression of the disease.

“There’s no doubt that the number of ACL injuries have increased, especially among children,” says Wojtys, associate professor of orthopaedic surgery at the U-M Medical School. “What’s concerning is that by the time those kids are in their late teens or early 20s, they’ll be living with osteoarthritis as a result of that ACL injury.”

He continues: “If our study can identify the earliest changes in the knee joint among these young athletes, we have the hope to do something to try to prevent the ongoing progress.”

The study, funded by National Football League Charities Foundation, will use sophisticated imaging such as MRI and biochemical techniques to look for changes in the knee joints of teens who have suffered ACL injuries.

Health Minute ImageACL injuries and arthritis
Each year, 1 out of 3,000 people will suffer from an ACL injury. While the injury is most common among children and teens, young female athletes are at the greatest risk. According to Wojtys, the ACL injury rate for a female college basketball team is near 1 in 40 players.

The ACL, located in the center of the knee joint, prevents the lower leg bone called the tibia from moving forward unexpectedly. It also plays a role in controlling rotation in the knee joint.

When injured, it can completely tear, resulting in a rupture, or partially tear, causing a sprain. An ACL will not heal by itself. It must be surgically reconstructed by using ligaments or tendons from another part of the body to replace the torn ACL. Rehabilitation after surgery is very complex, and it may take four to nine months to get back to regular activities, or 12 months for the knee to feel the way it used to.

“We’ve all seen the NFL football games where there’s a tremendous collision and then someone is carted off field. But in reality, most ACLs are ruptured in non-contact events,” explains Wojtys.

ACL injuries are frequently associated with damage to the delicate lining on the surface of bone that does not heal. Osteoarthritis is the result of continued deterioration to the bone surface and cartilage in joints. It is three times more common in women and it is a lifetime disease that progressively worsens.

U-M experts, through this new study, hope to learn whether or not the early stages of this degenerative disease can be prevented through altering the patient’s rehabilitation program, limiting certain activities after injury, or changing the timeframe for which a patient can return to playing sports.

Information about studies underway at the U-M Health System is available via the U-M Engage clinical research web site.

Find out more on the web at:
Sports Medicine Advisor: Anterior Cruciate Ligament Reconstruction

Sports Medicine Advisor: Anterior Cruciate Ligament (ACL) Sprain

Medline Plus Medical Encyclopedia: Anterior cruciate ligament (ACL) injury

Adult Health Advisor: Osteoarthritis

Written by Rossitza Iordanova


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