How Ligament Injuries Can Lead to Knee Osteoarthritis (OA)

We talk to Dr. Henry Chan of HC Orthopedic Surgery about how to avoid knee Osteoarthritis (OA) following a ligament injury


What is knee OA?

By a certain age, everyone has some wear and tear of the knee joint. Cartilage, the rubbery tissue that acts as a cushion between the bones of the joint, naturally wears down. The cartilage degeneration will make your knees bow out and cause secondary ligament and meniscus damage. But it can also happen the other way around: Ligament damage can cause joint instability, which in turn causes cartilage damage. The severity varies across people.


How does a ligament injury lead to OA?

With a ligament injury, your knee is more likely to buckle. Each time the bones turn, they wear down the cartilage and meniscus and cause arthritis. Your knee is like a car, a loose part may cause accidents. The more accidents, the more damaged the car.


How common is knee pain in Singapore?

Extremely common.  Eighty-to-ninety percent of joint replacements here are in the knee. According to the National Health Surveillance survey, about 10 percent of Singaporeans age 18 to 69 have arthritis and chronic joint symptoms. Sanofi, a health care provider, estimates 50 percent of Singaporeans have been affected by chronic knee pain.


When you talk about ligament injuries that can lead to OA, which ligaments and what types of injuries do you mean?

Mainly ACL. It’s the most important ligament for stabilization and the most commonly injured. The United States reports 100,000 ACL tears annually.


Should I wait as long as possible to have a replacement?

Replacements have their own lifespans. If you’re young, you may face multiple revision surgeries. It might make sense for you to wait until the pain is confining and you’re out of treatment options. However, if your quality of life is so severely affected that you can no longer walk to a nearby cafe for coffee, then we’ll recommend a knee replacement. We have plenty of tools and technologies to help us tackle the challenge of revision surgeries.


Will surgery help me achieve my normal levels of activity again?

With a knee replacement, you can fully regain your previous activity level but it might not feel as natural as it once did. You can, however, count on resuming most daily movements, i.e., walking on level ground, slopes, stairs, swimming, cycling, even squatting, with enough work and therapy.



Dr. Henry Chan is the Medical Director at HC Chan Orthopedics, a joint pain specialist at Mount Elizabeth Medical Centre (Orchard). He trained in Singapore and Germany for primary and complex joint replacement surgeries. Dr. Chan is also Adjunct Assistant Professor in the Department of Orthopedic Surgery in Yong Loo Lin School of Medicine, National University of Singapore. To date, he has performed more than 1000 joint replacements.


To learn more about Dr. Chan’s practice, click here.

For clinically proven conservative treatment to delay knee replacement surgery for Knee OA, click here.