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X-rays of my right knee taken five years after ACL surgery are showing the start of some arthritis in that knee. I don't feel any pain or stiffness. Is it just a matter of time before I start to have symptoms?

Follow-up studies are often necessary but there is truth to the old expression ignorance is bliss. What we don't know won't bother us. On the other hand, forewarned is forearmed applies here. Knowing there are subclinical signs of arthritis is a signal that it's time to get busy. Knee arthritis can be minimized with activity and exercise along with weight loss if you are overweight. Take measures now to protect your knees in this way. A strengthening program of exercises to balance out the hamstring muscles (behind the knee) and the quadriceps (on top of the thigh) is also important after ACL repair. Even a small difference between these two groups of muscles can lead to compression and overload on the joint. And studies show that it may be muscular imbalances that lead to the development of arthritis in the first place. A physical therapist can help you. The therapist can use a special device called an arthrometer to test joint laxity (looseness), a measure of joint stability/instability. Joint range of motion, muscle flexibility, and muscle strength can also be tested and restored to normal with a follow-up exercise program. Consider this type of approach insurance against future problems and complications. Since we know that arthritis occurs in half or more of all patients who have had ACL surgery, it makes sense to take steps now to protect yourself from this potentially disabling disease.

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