Knee crepitus, the audible crackling or grinding noise during knee joint movement, has been proposed as an early clinical indicator of structural osteoarthritis (OA). One year following anterior cruciate ligament reconstruction (ACLR), 112 participants self-reported the presence and/or absence of knee crepitus using an item from the Knee Injury and Osteoarthritis Outcome Score (KOOS). Patellofemoral and tibiofemoral osteoarthritis features (ie, cartilage lesions, osteophytes, and bone marrow lesions) were assessed from magnetic resonance imaging scans at 1 and 5 years after ACLR. Self-reported outcomes were assessed with 2 KOOS subscales (pain and quality of life [QoL]). Poisson regression evaluated the relationship between self-reported crepitus and the presence/worsening of structural osteoarthritis features. General linear models explored the relationship between crepitus and self-reported outcomes. Self-reported crepitus was associated with full-thickness patellofemoral cartilage lesions 1 year after ACLR (prevalence ratio 2.70, 95% confidence interval [CI] 1.41–6.39) but not the risk of worsening structural osteoarthritis features between 1 and 5 years after ACLR. Those with crepitus reported worse pain (β = -6.42, 95% CI -10.47 to -2.36), QoL (β = -10.39, 95% CI -18.58 to -2.20), and function (β = -5.49, 95% CI -10.92 to -0.06) 1 year after ACLR but greater improvement in pain and function between 1 and 5 years. Self-reported knee crepitus was associated with the presence of full-thickness patellofemoral cartilage defects 1 year after ACLR but was not associated with a greater risk of worsening structural osteoarthritis features up to 5 years after ACLR. One year after ACLR, those with crepitus reported worse pain, knee-related QoL, and function.
Source: Couch JL, Patterson BE, Crossley KM, et al. Knee crepitus and osteoarthritis features in young adults following traumatic knee injury. Arthritis Care Res (Hoboken). 2025. doi: 10.1002/acr.25637.
