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We aimed to determine the influence of a combined ACL<\/jats:styled-content> injury (i.e., concomitant meniscectomy and\/or arthroscopic chondral defect at the time of ACLR<\/jats:styled-content> and\/or secondary injury\/surgery to ACLR<\/jats:styled-content> knee) and cartilage defects defined on magnetic resonance imaging (MRI<\/jats:styled-content>), bone marrow lesions (BML<\/jats:styled-content>s), and meniscal lesions on patient\u2010reported outcomes 1 to 5 years after ACLR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>A total of 80 participants (50 men; mean \u00b1 SD<\/jats:styled-content> age 32 \u00b1 14 years) completed the Knee Injury and Osteoarthritis Outcome Score (KOOS<\/jats:styled-content>) and the International Knee Documentation Committee (IKDC<\/jats:styled-content>) questionnaires as well as a 3T MRI<\/jats:styled-content> assessment at 1 and 5 years after ACLR<\/jats:styled-content>. Median patient\u2010reported outcome scores were compared between isolated and combined ACL<\/jats:styled-content> injuries and with published normative values. Using multivariate regression, we evaluated the association between compartment\u2010specific MRI<\/jats:styled-content> cartilage, BML<\/jats:styled-content>s, and meniscal lesions and patient\u2010reported outcomes at 1 and 5 years.<\/jats:p><\/jats:sec>Results<\/jats:title>Individuals with a combined injury had significantly worse scores in the KOOS<\/jats:styled-content> subscale of function in sport and recreation (KOOS<\/jats:styled-content> sport\/rec) and in the IKDC<\/jats:styled-content> questionnaire at 1 year, and worse scores in the KOOS<\/jats:styled-content> subscales of pain (KOOS<\/jats:styled-content> pain), symptoms (KOOS<\/jats:styled-content> symptoms), and QoL (KOOS<\/jats:styled-content> QoL) and in the IKDC<\/jats:styled-content> questionnaire at 5 years compared to those with an isolated injury. Although no feature on MRI<\/jats:styled-content> was associated with patient\u2010reported outcomes cross\u2010sectionally at 1 year, patellofemoral cartilage defects at 1 year were significantly associated with worse 5\u2010year KOOS<\/jats:styled-content> symptoms (\u03b2 = \u20139.79, 95% confidence interval [95% CI<\/jats:styled-content>] \u201316.67, \u20132.91), KOOS<\/jats:styled-content> sport\/rec (\u03b2 = \u20137.94, 95% CI<\/jats:styled-content> \u201315.27, \u20130.61), KOOS<\/jats:styled-content> QoL (\u03b2 = \u20138.29, 95% CI<\/jats:styled-content> \u201315.28, \u20131.29), and IKDC<\/jats:styled-content> (\u03b2 = \u20134.79, 95% CI<\/jats:styled-content> \u20139.34, \u20130.24) scores. Patellofemoral cartilage defects at 5 years were also significantly associated with worse 5\u2010year KOOS<\/jats:styled-content> symptoms (\u03b2 = \u20136.86, 95% CI<\/jats:styled-content> \u201313.49, \u20130.24) and KOOS<\/jats:styled-content> QoL (\u03b2 = \u201311.71, 95% CI<\/jats:styled-content> \u201319.08, \u20134.33) scores.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Combined injury and patellofemoral cartilage defects shown on MRI<\/jats:styled-content> are associated with poorer long\u2010term outcomes. Clinicians should be vigilant and aware of individuals with these injuries, as such individuals may benefit from targeted interventions to improve QoL and optimize symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23854","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T08:49:36Z","timestamp":1550134176000},"page":"412-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Patient\u2010Reported Outcomes One to Five Years After Anterior Cruciate Ligament Reconstruction: The Effect of Combined Injury and Associations With Osteoarthritis Features Defined on Magnetic Resonance Imaging"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6570-5429","authenticated-orcid":false,"given":"Brooke E.","family":"Patterson","sequence":"first","affiliation":[{"name":"La Trobe Sport and Exercise Medicine Research Centre La Trobe University Bundoora Victoria 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