2004, Lohmander et al. 2007, Kay et al. 2018, Mok et al. 2019). Other unmeasured factors that may determine the risk of progression to osteoarthritis include genetic, biochemical, and biomechanical factors (Lohmander et al. 2007). In some circumstances, ACL reconstruction may be performed to stabilize a knee to facilitate a partial or total knee arthroplasty and these individuals are unlikely to be representative of the ACL “injury” population (Krishnan and Randle 2009, Weston-Simons et al. 2012). This evidence concerns the gene ACLY and osteoarthritis.