Date of Award

Spring 2023

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Solberg, Julie

Keywords

Knee injury and Osteoarthritis Outcome Score, post-traumatic osteoarthritis, knee injury, osteoarthritis, outcomes, conservative treatment, and surgical intervention

Abstract

The purpose of this research and systematic literature review is to determine the effectiveness of rest, physical therapy, and/or surgical intervention following either anterior cruciate ligament (ACL) or meniscus injuries in short- and long- term osteoarthritis outcomes. The short- and longterm outcomes were evaluated to compare the prevalence and progression of osteoarthritis after joint injury. In this literature review, the electronic database PubMed was used to find relevant research. Many keywords were used when searching for articles. Sources included for review had research on ACL or meniscus injuries specifically. Other knee injuries, non-knee injuries and non-human subjects were excluded. Articles involving surgical and/or physical therapy following joint injuries were included, and those involving injectables were excluded. For this review, 11 articles remained. Shown in both short- and long-term research, patients with ACL and meniscus injuries have a high prevalence of post-traumatic osteoarthritis (PTOA). Studies have shown that trialing physical therapy, specifically neuromuscular strengthening exercises, prior to surgical intervention greatly reduces the need for surgery, and that surgical intervention of ACL or meniscus injuries may increase PTOA prevalence due to additional joint injury. In other studies, surgical intervention of ACL injuries with or without formal physical therapy shows advantages in functional outcomes over physical therapy alone. However, patients with meniscus injuries are shown to have better functional and osteoarthritis outcomes when avoiding surgical intervention and opting for physical therapy instead. Determining the best options for patients after knee joint injury should be made on a case-by-case basis until more research can be done to determine the best overall preventative treatment for PTOA.

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