I had an ACL repair about 10 years ago. I was able to return to competitive sports but now I found out I'm starting to get arthritis in that knee. I guess I thought the knee would be better than ever. Does this happen to everyone?

Any major trauma or injury to the joints seems to be linked with osteoarthritis later on. Studies show that about 10 percent of the patients who have an anterior cruciate ligament (ACL) repair later show signs of arthritis.

At first there is a narrowing of the joint space seen only on X-ray. The patient usually doesn't have any symptoms yet. Athletes are more likely to start seeing some changes about 10 years after the injury. The problem is delayed in less active adults until closer to age 40 or even 50.

Type of injury and type of surgical repair may make a difference. Patients who had a meniscal tear and an ACL tear at the same time had earlier onset of arthritis than patients who just had an ACL tear. There are fewer cases (four percent) of arthritis in patients who have the ACL repaired with a hamstring tendon graft. This is compared with 18 percent for patients receiving a patellar tendon graft.

So all in all, a small number of folks develop arthritis. There's probably a combination of risk factors that result in this group having problems while others don't seem to develop arthritis until older age.

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