Athletic Injury and Rehabilitation Labs

Preventing Osteoarthritis After Knee Injury

Every year, thousands of young athletes tear their ACL. Surgery restores knee stability—but for many, recovery remains incomplete. Up to 1 in 3 develop osteoarthritis within a decade. We're working to change that.

Led by Dr. Matt Harkey at Michigan State University, our lab is redefining how we understand recovery after ACL reconstruction. We've identified a critical stage—pre-osteoarthritis illness—where persistent symptoms signal elevated risk for future joint damage. By catching problems at this stage, we can intervene before irreversible changes occur.

Our Research: Recognizing Pre-OA Illness as a Window for Prevention

sparty and people smiling and posing for a picture

Traditional approaches wait until X-rays show joint damage before diagnosing osteoarthritis. By then, the opportunity for prevention has passed. Our research identifies pre-osteoarthritis (pre-OA) illness—a stage where patients have persistent symptoms after ACL reconstruction but no radiographic evidence of arthritis yet.

This isn't just slower recovery. It's an early warning sign.

Our work shows that 54% of patients meet criteria for pre-OA illness at 6 months post-surgery. These patients are 3× more likely to develop arthritis within 5 years. They need closer monitoring and earlier intervention.

We integrate three approaches to identify high-risk patients and test preventive interventions:

Shifting the Paradigm: From Reactive to Preventive Care

Traditional OA care: Wait until X-rays show damage → Manage pain → Eventually replace the joint

Our approach: Identify pre-OA illness early → Target inflammation and abnormal loading → Prevent irreversible damage

This shift mirrors how medicine now treats cardiovascular and metabolic diseases—intervening before irreversible pathology emerges. The difference? Patients who develop chronic pain and arthritis in their 30s and 40s versus patients who maintain joint health for life.

Impact at a Glance

Research Impact

70+ peer-reviewed publications since 2020
100+ national/international conference presentations since 2020
3,800+ citations from researchers worldwide

Funding & Translation

$6.2 million in research funding from NIH, Department of Defense, and national foundations
Partnerships with Sparrow Health and MSU Health orthopedic surgeons
Contributed to CDC-supported national guidelines for OA prevention after injury

Why This Matters: The Subset That Can't Wait

Not all patients need to be labeled as having pre-OA illness. But for the substantial proportion—

54% at 6 months, 33% with persistent symptoms through 2 years—who continue experiencing pain, functional limitations, and reduced quality of life, this construct ensures their symptoms aren't dismissed as 'normal recovery.'

Recognizing pre-OA illness:

Justifies extended rehabilitation and structured follow-up
Enables targeted symptom management (pain relief, psychological support, movement retraining)
Creates eligibility for clinical trials testing disease-modifying interventions
Shifts the focus from reacting to joint damage to preventing it

The alternative? Waiting until X-rays show irreversible damage—when prevention is no longer possible.

Now is the time to act.

sparty conducting rehab on people laying on a table and showing xrays