Anterior cruciate ligament and intercondylar notch growth plateaus prior to cessation of longitudinal growth: an MRI observational study

Tuca, María; Hayter, Catherine L.; Potter, Hollis G.; Marx, Robert G.; Green, Daniel W.

doi:10.1007/s00167-016-4021-5

Cited by 29 publications

(32 citation statements)

References 44 publications

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“…Their finding supports the prevailing dogma of the field that these morphological traits are largely non‐modifiable after the pre‐pubescence phase . However, the findings of Tuca et al research is inconsistent with other musculoskeletal studies conducted on high activity individuals. Bone, muscle, and tendinous size are significantly different morphologically in the dominantly loaded musculoskeletal element of individuals compared with their non‐dominant contralateral and in comparison with individuals that had a lower activity level throughout growth (both pre‐ and post‐puberty) …”

mentioning

confidence: 78%

“…How the morphology of these anatomical traits is biomechanically influenced throughout growth via differentially applied physiological loads is of considerable clinical importance yet remains unclear. Interestingly, Tuca et al recently reported their findings from a magnetic resonance imaging study conducted on boys and girls ranging from 3 to 14 years old that suggested the significant growth in ACL volume and femoral intercondylar notch volume plateaued by 10 years of age in both sexes. Their finding supports the prevailing dogma of the field that these morphological traits are largely non‐modifiable after the pre‐pubescence phase .…”

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confidence: 99%

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Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Schlecht

Martin

Ochocki

et al. 2019

Journal Orthopaedic Research

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Postnatal development and the physiological loading response of the anterior cruciate ligament (ACL) complex (ACL proper, entheses, and bony morphology) is not well understood. We tested whether the ACL-complex of two inbred mouse strains that collectively encompass the musculoskeletal variation observed in humans would demonstrate significant morphological differences following voluntary cage-wheel running during puberty compared with normal cage activity controls. Female A/J and C57BL/6J (B6) 6-week-old mice were provided unrestricted access to a standard cage-wheel for 4 weeks. A/J-exercise mice showed a 6.3% narrower ACL (p = 0.64), and a 20.1% more stenotic femoral notch (p < 0.01) while B6-exercise mice showed a 12.3% wider ACL (p = 0.10), compared with their respective controls. Additionally, A/J-exercise mice showed a 5.3% less steep posterior medial tibial slope (p = 0.07) and an 8.8% less steep posterior lateral tibial slope (p = 0.07), while B6-exercise mice showed a 9.8% more steep posterior medial tibial slope (p < 0.01) than their respective controls. A/J-exercise mice also showed more reinforcement of the ACL tibial enthesis with a 20.4% larger area (p < 0.01) of calcified fibrocartilage distributed at a 29.2% greater depth (p = 0.02) within the tibial enthesis, compared with their controls. These outcomes suggest exercise during puberty significantly influences ACL-complex morphology and that inherent morphological differences between these mice, as observed in their less active genetically similar control groups, resulted in a divergent phenotypic outcome between mouse strains.

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confidence: 78%

mentioning

confidence: 99%

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Schlecht

Martin

Ochocki

et al. 2019

Journal Orthopaedic Research

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“…Further work is needed to expand data that can be studied in both human and porcine models through non‐invasive methods, including imaging based analysis of tissue size and geometry (e.g., tissue volume, CSA, and length). These parameters can be evaluated at a higher resolution through high‐strength MR imaging in both humans and the porcine model, which may be particularly important for smaller (i.e., younger) specimens . This may provide further verification that the porcine model has the potential to mimic complex processes involved in the growth of pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

“…These parameters can be evaluated at a higher resolution through high-strength MR imaging in both humans and the porcine model, which may be particularly important for smaller (i.e., younger) specimens. [27][28][29] This may provide further verification that the porcine model has the potential to mimic complex processes involved in the growth of pediatric patients. Following further investigation of non-invasive parameters, characteristics including the biomechanical properties of musculoskeletal soft tissues will be investigated in the skeletally immature porcine model and/ or through correlation analysis of imaging parameters and tissue properties.…”

Section: Age-dependent Cruciate Ligament Orientationmentioning

confidence: 91%

Orientation changes in the cruciate ligaments of the knee during skeletal growth: A porcine model

Cone

Simpson

Piedrahita

et al. 2017

Journal Orthopaedic Research

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Musculoskeletal injuries in pediatric patients are on the rise, including significant increases in anterior cruciate ligament (ACL) injuries. Previous studies have found major anatomical changes during skeletal growth in the soft tissues of the knee. Specifically, the ACL and the posterior cruciate ligament (PCL) change in their relative orientation to the tibial plateau throughout growth. In order to develop age-specific treatments for ACL injuries, the purpose of this study was to characterize orientation changes in the cruciate ligaments of the Yorkshire pig, a common pre-clinical model, during skeletal growth in order to verify the applicability of this model for pediatric musculoskeletal studies. Hind limbs were isolated from female Yorkshire pigs ranging in age from newborn to late adolescence, and were then imaged using high field strength magnetic resonance imaging. Orientation changes were quantified from the magnetic resonance images using image segmentation software. Statistically significant increases were found in the coronal and sagittal angles of the ACL relative to the tibial plateau during pre-adolescent growth. Additional changes were observed in the PCL angle, Blumensaat angle, intercondylar roof angle, and the aspect ratio of the intercondylar notch. Only the sagittal angle of the ACL relative to the tibial plateau experienced statistically significant changes through late adolescence. The age-dependent properties of the ACL and PCL in the female pig mirrored results found in female human patients, suggesting that the porcine model may provide a pre-clinical platform to study the cruciate ligaments during skeletal growth.

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“…An MRI analysis of 132 normal knees spanning the ages of 4 years to 18 years revealed that the ACL diameter grows from 6.5 to 9.8 mm over this period, which may have implications when assessing graft sizes for patients [22•]. Another recent study analyzed 137 knee MRIs performed between 2006 and 2010 in patients aged 3-13 and described a plateau in this ACL growth and notch volume at age 10, with females having smaller intercondylar notch volumes than males [23]. There has been some evidence showing that knees with ACL tears have smaller notch volumes than knees with intact ACLs [24].…”

Section: Acl and Physeal Anatomymentioning

confidence: 99%

Anterior cruciate ligament reconstruction in skeletally immature patients

Pennock

Murphy

2016

Curr Rev Musculoskelet Med

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The management of pediatric patients with an anterior cruciate ligament (ACL) tear can be a challenging endeavor for physicians, athletic trainers, coaches, and parents alike. In particular, the significant longitudinal growth that arises from the physes about the knee creates a unique set of circumstances that must be considered in this patient population. The purpose of this review is to provide a summary of the most recent current literature for the management of skeletally immature patients with an ACL tear.

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Anterior cruciate ligament and intercondylar notch growth plateaus prior to cessation of longitudinal growth: an MRI observational study

Abstract: Observational Study, Level IV.

Cited by 29 publications

References 44 publications

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Morphology of Mouse Anterior Cruciate Ligament‐Complex Changes Following Exercise During Pubertal Growth

Orientation changes in the cruciate ligaments of the knee during skeletal growth: A porcine model

Anterior cruciate ligament reconstruction in skeletally immature patients

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