Post-traumatic osteoarthritis (PTOA) occurs as a conse- quence of joint trauma or occupations or sports that sub- ject joints to excessive loading stresses. Ligament injuries to the knee, particularly tears of the anterior cruciate lig- ament (ACL), often result in PTOA. Approximately half of the individuals with an ACL injury develop PTOA re- gardless of the reconstruction of the torn ligament. This observation has raised the possibility that other injuries occur to the knee in association with ACL tears that may involve ligamentous capsular structures, articular carti- lage, or subchondral bone. Many ACL injuries occur in noncontact sports and are the result of biomechanical ab- normalities. Female athletes are more likely than their male counterparts to suffer ACL injuries. This review outlines the epidemiology of ACL tears, its pathology in cartilage and bone, some of the demographic, biome- chanical, and neuromuscular factors involved in ACL tears, and PTOA and important information gained from preclinical injury models.
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