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Arthroscopy. 2019 Feb;35(2):511-520. doi: 10.1016/j.arthro.2018.07.033. Epub 2018 Nov 22.

Abnormal Biomechanics at 6 Months Are Associated With Cartilage Degeneration at 3 Years After Anterior Cruciate Ligament Reconstruction.

Author information

1
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.; Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
2
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, U.S.A.
3
Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, U.S.A.; Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, California, U.S.A.
4
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, U.S.A.. Electronic address: maben@orthosurg.ucsf.edu.

Abstract

PURPOSE:

To investigate the changes in landing biomechanics over a 3-year period and their correlation with cartilage degenerative changes in the medial tibiofemoral joint of the knee after anterior cruciate ligament reconstruction (ACLR) using magnetic resonance T1ρ mapping.

METHODS:

Thirty-one anterior cruciate ligament-injured patients underwent magnetic resonance imaging of the injured knee before ACLR and 3 years after ACLR, as well as biomechanical analysis of a drop-landing task at 6 months and 3 years after ACLR. Sixteen healthy individuals were recruited and underwent knee magnetic resonance imaging and biomechanical assessment during a drop-landing task. T1ρ cartilage relaxation times were calculated for the medial femur and tibia.

RESULTS:

ACLR patients exhibited increased peak vertical ground reaction force (VGRF), VGRF impulse, peak knee flexion moment (KFM), and KFM impulse from 6 months to 3 years (P < .001 for each). Although the ACLR knees showed significantly lower peak VGRF and KFM at 6 months (P < .001 for both) when compared with the controls, there were no significant differences at 3 years. At 3 years, ACLR patients showed higher T1ρ values over the medial femur (P < .001) and tibia (P = .012) when compared with their preoperative values and with healthy control values. Within the ACLR group, side-to-side differences in peak VGRF and sagittal knee biomechanics at 6 months were associated with increased T1ρ values from baseline to 3 years.

CONCLUSIONS:

The results of this longitudinal study show that landing biomechanics are altered after ACLR but biomechanical abnormalities tend to recover at 3 years after ACLR. Differences in lower-extremity mechanics during a landing task at 6 months may be associated with cartilage degeneration at 3 years after anterior cruciate ligament injury and reconstruction.

LEVEL OF EVIDENCE:

Level II, prospective trial.

PMID:
30473456
PMCID:
PMC6361700
[Available on 2020-02-01]
DOI:
10.1016/j.arthro.2018.07.033

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