Tibiofemoral contact and alignment in patients with anterior cruciate ligament rupture treated nonoperatively versus reconstruction
| Autor: | Andrew Yung, Bassam A. Masri, David R. Wilson, Jane Desrochers, Andrew M Schmidt, Honglin Zhang, David J. Stockton |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Rotation Anterior cruciate ligament Osteoarthritis Weight-Bearing medicine Humans Orthopedics and Sports Medicine In patient Femur Anterior cruciate ligament rupture Mri scan Anterior Cruciate Ligament Reconstruction Tibia business.industry Anterior Cruciate Ligament Injuries musculoskeletal system medicine.disease Magnetic Resonance Imaging ACL injury Biomechanical Phenomena Surgery medicine.anatomical_structure Standing Position Female Open mri business human activities |
| Zdroj: | The Bone & Joint Journal. :1505-1513 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.103b9.bjj-2020-1955.r1 |
| Popis: | Aims Anterior cruciate ligament (ACL) rupture commonly leads to post-traumatic osteoarthritis, regardless of surgical reconstruction. This study uses standing MRI to investigate changes in contact area, contact centroid location, and tibiofemoral alignment between ACL-injured knees and healthy controls, to examine the effect of ACL reconstruction on these parameters. Methods An upright, open MRI was used to directly measure tibiofemoral contact area, centroid location, and alignment in 18 individuals with unilateral ACL rupture within the last five years. Eight participants had been treated nonoperatively and ten had ACL reconstruction performed within one year of injury. All participants were high-functioning and had returned to sport or recreational activities. Healthy contralateral knees served as controls. Participants were imaged in a standing posture with knees fully extended. Results Participants’ mean age was 28.4 years (SD 7.3), the mean time since injury was 2.7 years (SD 1.6), and the mean International Knee Documentation Subjective Knee Form score was 84.4 (SD 13.5). ACL injury was associated with a 10% increase (p = 0.001) in contact area, controlling for compartment, sex, posture, age, body mass, and time since injury. ACL injury was associated with a 5.2% more posteriorly translated medial centroid (p = 0.001), equivalent to a 2.6 mm posterior translation on a representative tibia with mean posteroanterior width of 49.4 mm. Relative to the femur, the tibiae of ACL ruptured knees were 2.3 mm more anteriorly translated (p = 0.003) and 2.6° less externally rotated (p = 0.010) than healthy controls. ACL reconstruction was not associated with an improvement in any measure. Conclusion ACL rupture was associated with an increased contact area, posteriorly translated medial centroid, anterior tibial translation, and reduced tibial external rotation in full extension. These changes were present 2.7 years post-injury regardless of ACL reconstruction status. Cite this article: Bone Joint J 2021;103-B(9):1505–1513. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|