November 24, 2023

ACL-injured patients are young and a substantial proportion develop OA regardless of treatment strategy. Severity of traumatic structural damage is relevant for risk of later OA development. Case shows images directly post-injury, at 4, 7, 12 and 24 months. Baseline shows osteochondral fracture of the lateral femur (arrow) and traumatic BMLs in the femur and tibia. Traumatic BMLs regress from BL to 4 months when a new BML is seen at the fast posterior lateral femur is seen, likely due to stress or trauma. At 7 months, no BML is observed, at 12 months there is an incident degenerative BML associated with new cartilage damage in the lateral femur (arrows). Cartilage damage is getting worse at 24 months but BML regresses. (All images from KANON trial).