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Relationships Between Tibiofemoral Contact Forces and Cartilage Morphology at 2 to 3 Years After Single-Bundle Hamstring Anterior Cruciate Ligament Reconstruction and in Healthy Knees.

Abstract Prevention of knee osteoarthritis (OA) following anterior cruciate ligament (ACL) rupture and reconstruction is vital. Risk of postreconstruction knee OA is markedly increased by concurrent meniscal injury. It is unclear whether reconstruction results in normal relationships between tibiofemoral contact forces and cartilage morphology and whether meniscal injury modulates these relationships.
PMID
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Authors

Mayor MeshTerms
Keywords

anterior cruciate ligament reconstruction

knee contact forces

meniscus

osteoarthritis

tibiofemoral cartilage

Journal Title orthopaedic journal of sports medicine
Publication Year Start




PMID- 28894756
OWN - NLM
STAT- PubMed-not-MEDLINE
DA  - 20170912
LR  - 20170914
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Linking)
VI  - 5
IP  - 8
DP  - 2017 Aug
TI  - Relationships Between Tibiofemoral Contact Forces and Cartilage Morphology at 2
      to 3 Years After Single-Bundle Hamstring Anterior Cruciate Ligament
      Reconstruction and in Healthy Knees.
PG  - 2325967117722506
LID - 10.1177/2325967117722506 [doi]
AB  - BACKGROUND: Prevention of knee osteoarthritis (OA) following anterior cruciate
      ligament (ACL) rupture and reconstruction is vital. Risk of postreconstruction
      knee OA is markedly increased by concurrent meniscal injury. It is unclear
      whether reconstruction results in normal relationships between tibiofemoral
      contact forces and cartilage morphology and whether meniscal injury modulates
      these relationships. HYPOTHESES: Since patients with isolated reconstructions
      (ie, without meniscal injury) are at lower risk for knee OA, we predicted that
      relationships between tibiofemoral contact forces and cartilage morphology would 
      be similar to those of normal, healthy knees 2 to 3 years postreconstruction. In 
      knees with meniscal injuries, these relationships would be similar to those
      reported in patients with knee OA, reflecting early degenerative changes. STUDY
      DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Three groups were
      examined: (1) 62 patients who received single-bundle hamstring reconstruction
      with an intact, uninjured meniscus (mean age, 29.8 +/- 6.4 years; mean weight,
      74.9 +/- 13.3 kg); (2) 38 patients with similar reconstruction with additional
      meniscal injury (ie, tear, repair) or partial resection (mean age, 30.6 +/- 6.6
      years; mean weight, 83.3 +/- 14.3 kg); and (3) 30 ligament-normal, healthy
      individuals (mean age, 28.3 +/- 5.2 years; mean weight, 74.9 +/- 14.9 kg) serving
      as controls. All patients underwent magnetic resonance imaging to measure the
      medial and lateral tibial articular cartilage morphology (volumes and
      thicknesses). An electromyography-driven neuromusculoskeletal model determined
      medial and lateral tibiofemoral contact forces during walking. General linear
      models were used to assess relationships between tibiofemoral contact forces and 
      cartilage morphology. RESULTS: In control knees, cartilage was thicker compared
      with that of isolated and meniscal-injured ACL-reconstructed knees, while greater
      contact forces were related to both greater tibial cartilage volumes (medial: R2 
      = 0.43, beta = 0.62, P = .000; lateral: R2 = 0.19, beta = 0.46, P = .03) and
      medial thicknesses (R2 = 0.24, beta = 0.48, P = .01). In the overall group of
      ACL-reconstructed knees, greater contact forces were related to greater lateral
      cartilage volumes (R2 = 0.08, beta = 0.28, P = .01). In ACL-reconstructed knees
      with lateral meniscal injury, greater lateral contact forces were related to
      greater lateral cartilage volumes (R2 = 0.41, beta = 0.64, P = .001) and
      thicknesses (R2 = 0.20, beta = 0.46, P = .04). CONCLUSION: At 2 to 3 years
      postsurgery, ACL-reconstructed knees had thinner cartilage compared with healthy 
      knees, and there were no positive relationships between medial contact forces and
      cartilage morphology. In lateral meniscal-injured reconstructed knees, greater
      contact forces were related to greater lateral cartilage volumes and thicknesses,
      although it was unclear whether this was an adaptive response or associated with 
      degeneration. Future clinical studies may seek to establish whether cartilage
      morphology can be modified through rehabilitation programs targeting contact
      forces directly in addition to the current rehabilitation foci of restoring
      passive and dynamic knee range of motion, knee strength, and functional
      performance.
CN  - Young People With Old Knees Research Team
FAU - Saxby, David John
AU  - Saxby DJ
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Bryant, Adam L
AU  - Bryant AL
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Wang, Xinyang
AU  - Wang X
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Modenese, Luca
AU  - Modenese L
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Gerus, Pauline
AU  - Gerus P
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Konrath, Jason M
AU  - Konrath JM
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Bennell, Kim L
AU  - Bennell KL
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Fortin, Karine
AU  - Fortin K
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Wrigley, Tim
AU  - Wrigley T
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Cicuttini, Flavia M
AU  - Cicuttini FM
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Vertullo, Christopher J
AU  - Vertullo CJ
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Feller, Julian A
AU  - Feller JA
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Whitehead, Tim
AU  - Whitehead T
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Gallie, Price
AU  - Gallie P
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
FAU - Lloyd, David G
AU  - Lloyd DG
AD  - Investigation performed at School of Allied Health Sciences, Griffith University,
      Gold Coast, Australia; Centre for Health, Exercise and Sports Medicine,
      University of Melbourne, Melbourne, Australia; and the Department of Epidemiology
      and Preventive Medicine, Monash University, Melbourne, Australia.
LA  - eng
PT  - Journal Article
DEP - 20170831
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
PMC - PMC5582666
OTO - NOTNLM
OT  - anterior cruciate ligament reconstruction
OT  - knee contact forces
OT  - meniscus
OT  - osteoarthritis
OT  - tibiofemoral cartilage
COI - One or more of the authors has declared the following potential conflict of
      interest or source of funding: Funding support for this research was received
      from the Australian National Health and Medical Research Council to A.L.B.,
      D.G.L., K.L.B., and F.M.C. (grant No. 628850), as well as the National Health and
      Medical Research Council R.D. Wright Biomedical Fellowship and Principal Research
      Fellowship to authors A.L.B. and K.L.B., respectively. The work of author L.M.
      was supported by the UK Engineering and Physical Sciences Research Council
      through grant EP/K03877X/1. D.J.S. received a PhD scholarship and stipend awards 
      from Griffith University, as well as a PhD matching dissertation grant from the
      International Society of Biomechanics. T.W. is a lecturer for Smith & Nephew and 
      Arthrex, receives research support from Smith & Nephew, and is a consultant for
      Medacta. C.J.V. receives funding from Smith & Nephew.
EDAT- 2017/09/13 06:00
MHDA- 2017/09/13 06:01
CRDT- 2017/09/13 06:00
AID - 10.1177/2325967117722506 [doi]
AID - 10.1177_2325967117722506 [pii]
PST - epublish
SO  - Orthop J Sports Med. 2017 Aug 31;5(8):2325967117722506. doi:
      10.1177/2325967117722506. eCollection 2017 Aug.