|dc.contributor.author||Johnson, Victoria Louise||-|
|dc.description.abstract||The knee is one of the most commonly injured joints with injury to the anterior cruciate ligament (ACL) being strongly associated with an increased risk of knee osteoarthritis (OA). As the risk of ACL injury is highest amongst adolescents who participate in sports the majority of the literature has focused on knee injury amongst this cohort. It is not currently understood whether a similar relationship exists in an elderly population.
This thesis utilised participants from two different cohorts, the first being the Osteoarthritis Initiative (OAI), which is an ongoing 10-year, multi-centered, prospective observational study designed to identify risk factors for the development and progression of knee OA. This cohort was utilized in chapters 3, 5, 6 and 7 to investigate whether elderly individuals with an ACL tear were at an increased risk of radiographic knee OA and to further examine the relationship between the severity of radiographic disease and the extent of injury to the ACL and the surrounding tissues as well as for the presence of knee symptoms. The second cohort was a 15-year prospective, longitudinal, single center study that contained participants who underwent primary reconstruction following ACL rupture. This cohort was utilized in chapter 4 to assess whether an age-related dose-response relationship existed for incident radiographic knee OA following ACL injury.
Overall, knees that had a loss of ACL integrity secondary to age-related degeneration did not have an increased risk of incident radiographic knee OA. However, an ACL injury sustained in an aged knee was associated with an increased risk of radiographic OA development within the first 5 to 10 years of the initial injury and an increased risk of region specific disease progression secondary to meniscal and subchondral bone pathology. Overall joint damage patterns were similar amongst individuals with either a partial or complete ACL rupture suggesting that joint health carries a similar prognosis regardless of the extent of ACL fiber disruption. Finally, a loss of ACL integrity and radiographic OA severity was also associated with knee disability.
Whilst injuries amongst the younger, active population have been the focus of study for the association of injuries and OA, injury amongst older adults demands significant attention.||en_AU|
|dc.publisher||University of Sydney||en_AU|
|dc.publisher||Sydney Medical School||en_AU|
|dc.publisher||Institute of Bone and Joint Research||en_AU|
|dc.rights||The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.||en_AU|
|dc.subject||Magnetic Resonance Imaging (MRI)||en_AU|
|dc.subject||Anterior Cruciate Ligament (ACL)||en_AU|
|dc.subject.other||! includes published articles||en_AU|
|dc.title||The loss of anterior cruciate ligament integrity and the development of radiographic knee osteoarthritis||en_AU|
|dc.type.pubtype||Doctor of Philosophy Ph.D.||en_AU|
|Appears in Collections:||Sydney Digital Theses (Open Access)|