Effects of Surgical Factors on Cartilage Can Be Detected Using                     Quantitative Magnetic Resonance Imaging After Anterior Cruciate Ligament                     Reconstruction

Amano, Keiko; Li, Alan K.; Pedoia, Valentina; Koff, Matthew F.; Krych, Aaron J.; Link, Thomas M.; Potter, Hollis G.; Rodeo, Scott A.; Li, Xiaojuan; Benjamin, C.; Majumdar, Sharmila

doi:10.1177/0363546516677794

Cited by 17 publications

(20 citation statements)

References 49 publications

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“…A previous comparison of quantitative cartilage MRI metrics and PROs following ACL reconstruction found that side-to-side differences in cartilage T1rho values measured prior to surgery were predictive of all KOOS outcomes except for sports function at 1 year following surgery 48 . In a larger study, prolonged T1rho and T2 values were associated with worse KOOS Symptoms, Pain and Activities of Daily Living measured 6 months post-surgery 49 . The observed small but significant correlation between decreased UTE-T2* profile slope and worse KOOS Symptoms at just 2 years after ACLR in the current study similarly shows a potential relationship between cartilage structural changes and clinical outcomes.…”

Section: Discussionmentioning

confidence: 79%

MRI UTE-T2* profile characteristics correlate to walking mechanics and patient reported outcomes 2 years after ACL reconstruction

Titchenal

Andriacchi

et al. 2018

Osteoarthritis and Cartilage

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SUMMARY Objective Quantitative magnetic resonance imaging (MRI) ultrashort echo time (UTE) T2* is sensitive to cartilage deep tissue matrix changes after anterior cruciate ligament reconstruction (ACLR). This study was performed to determine whether UTE-T2* profile analysis is a useful clinical metric for assessing cartilage matrix degeneration. This work tests the hypotheses that UTE-T2* depthwise rates of change (profile slopes) correlate with clinical outcome metrics of walking mechanics and patient reported outcomes (PRO) in patients 2 years after ACLR. Design Thirty-six patients 2 years after ACLR completed knee MRI, gait analysis, and PRO. UTE-T2* maps were generated from MRI images and depthwise UTE-T2* profiles were calculated for weight-bearing cartilage in the medial compartment. UTE-T2* profiles from 14 uninjured subjects provided reference values. UTE-T2* profile characteristics, including several different measures of profile slope, were tested for correlation to kinetic and kinematic measures of gait and also to PRO. Results Decreasing UTE-T2* profile slopes in ACLR knees moderately correlated with increasing knee adduction moments (r = 0.41, P < 0.015), greater external tibial rotation (r = 0.44, P = 0.007), and moderately negatively correlated with PRO (r = −0.36, P = 0.032). UTE-T2* profiles from both ACLR and contralateral knees of ACLR subjects differed from that of uninjured controls (P < 0.015). Conclusions The results of this study suggest that decreasing UTE-T2* profile slopes reflect cartilage deep tissue collagen matrix disruption in a population at increased risk for knee osteoarthritis (OA). That UTE-T2* profiles were associated with mechanical and patient reported measures of clinical outcomes support further study into a potential mechanistic relationship between these factors and OA development.

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Section: Discussionmentioning

confidence: 79%

MRI UTE-T2* profile characteristics correlate to walking mechanics and patient reported outcomes 2 years after ACL reconstruction

Titchenal

Andriacchi

et al. 2018

Osteoarthritis and Cartilage

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“…Composite metric sequences including T 1ρ and T 2 have been associated with the PROM KOOS, pain after ACL reconstruction and with synovial fluid biomarkers at the time of surgery30, 31, 32. Change in these compositional measures may reflect differences in surgical factors after ACL reconstruction and the pre-injury joint structure 33 .…”

Section: Resultsmentioning

confidence: 99%

Towards prevention of post-traumatic osteoarthritis: report from an international expert working group on considerations for the design and conduct of interventional studies following acute knee injury

Watt

Corp

Kingsbury

et al. 2019

Osteoarthritis and Cartilage

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“…These regional alterations in loading may affect cartilage health (proteoglycan content and collagen organization) and may be more accurately assessed by quantitative magnetic resonance imaging including T1rho and T2 scanning protocols. 3,53 Such modalities provide more detailed and earlier information on cartilage health than commonly used radiographic measures and may be useful to determine whether ACLR augmented with LET accelerates cartilage degeneration. 38 Differences between our study and previously published work include surgical technique, applied loads, and the conditions of the knee that were compared.…”

Section: Discussionmentioning

confidence: 99%

Lateral Extra-articular Tenodesis Alters Lateral Compartment Contact Mechanics under Simulated Pivoting Maneuvers: An In Vitro Study

et al. 2021

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Background: There is concern that utilization of lateral extra-articular tenodesis (LET) in conjunction with anterior cruciate ligament (ACL) reconstruction (ACLR) may disturb lateral compartment contact mechanics and contribute to joint degeneration. Hypothesis: ACLR augmented with LET will alter lateral compartment contact mechanics in response to simulated pivoting maneuvers. Study Design: Controlled laboratory study. Methods: Loads simulating a pivot shift were applied to 7 cadaveric knees (4 male; mean age, 39 ± 12 years; range, 28-54 years) using a robotic manipulator. Each knee was tested with the ACL intact, sectioned, reconstructed (via patellar tendon autograft), and, finally, after augmenting ACLR with LET (using a modified Lemaire technique) in the presence of a sectioned anterolateral ligament and Kaplan fibers. Lateral compartment contact mechanics were measured using a contact stress transducer. Outcome measures were anteroposterior location of the center of contact stress (CCS), contact force from anterior to posterior, and peak and mean contact stress. Results: On average, augmenting ACLR with LET shifted the lateral compartment CCS anteriorly compared with the intact knee and compared with ACLR in isolation by a maximum of 5.4 ± 2.3 mm ( P < .001) and 6.0 ± 2.6 mm ( P < .001), respectively. ACLR augmented with LET also increased contact force anteriorly on the lateral tibial plateau compared with the intact knee and compared with isolated ACLR by a maximum of 12 ± 6 N ( P = .001) and 17 ± 10 N ( P = .002), respectively. Compared with ACLR in isolation, ACLR augmented with LET increased peak and mean lateral compartment contact stress by 0.7 ± 0.5 MPa ( P = .005) and by 0.17 ± 0.12 ( P = .006), respectively, at 15° of flexion. Conclusion: Under simulated pivoting loads, adding LET to ACLR anteriorized the CCS on the lateral tibial plateau, thereby increasing contact force anteriorly. Compared with ACLR in isolation, ACLR augmented with LET increased peak and mean lateral compartment contact stress at 15° of flexion. Clinical Relevance: The clinical and biological effect of increased anterior loading of the lateral compartment after LET merits further investigation. The ability of LET to anteriorize contact stress on the lateral compartment may be useful in knees with passive anterior subluxation of the lateral tibia.

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Effects of Surgical Factors on Cartilage Can Be Detected Using Quantitative Magnetic Resonance Imaging After Anterior Cruciate Ligament Reconstruction

Cited by 17 publications

References 49 publications

MRI UTE-T2* profile characteristics correlate to walking mechanics and patient reported outcomes 2 years after ACL reconstruction

MRI UTE-T2* profile characteristics correlate to walking mechanics and patient reported outcomes 2 years after ACL reconstruction

Towards prevention of post-traumatic osteoarthritis: report from an international expert working group on considerations for the design and conduct of interventional studies following acute knee injury

Lateral Extra-articular Tenodesis Alters Lateral Compartment Contact Mechanics under Simulated Pivoting Maneuvers: An In Vitro Study

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