Anterior Cruciate Ligament Degeneration Linked With Aging and Osteoarthritis

There is a general association between anterior cruciate ligament (ACL) degeneration and aging and between ACL degeneration and cartilage degeneration. ACL changes may precede or initiate cartilage damage or occur simultaneously with or subsequent to cartilage lesions.

Hasegawa and colleagues investigated the types and temporal sequence of age-related ACL changes to determine their correlation with cartilage lesion patterns at all stages of osteoarthritis development in human knee joints without previous joint trauma. Joints from donors aged 23 to 92 years were obtained at autopsy, and ACLs and cartilage were graded macroscopically and histologically. Inflammation around the ACL was assessed separately.

The total ACL score, the sum of histological changes within the ACL, increased with donor age. That score correlated significantly with the total knee cartilage score and was most strongly correlated with the medial compartment cartilage score. Positive correlations were seen between ligament sheath inflammation score and donor age, the ACL substance inflammation and total ACL scores, and ligament sheath inflammation and total ACL scores. The earliest and most prevalent change was collagen fiber disorganization; latest and least prevalent was calcification.

The authors proposed a temporal sequence of histopathological changes based on all parameters examined in the ACL sample set.