Longitudinal Effects of Acute Anterior Cruciate Ligament Tears on Peri‐Articular Bone in Human Knees Within the First Year of Injury

Kroker, Andres; Besler, Bryce A.; Bhatla, Jennifer L; Shtil, Mariya; Salat, Peter; Mohtadi, Nicholas; Walker, Richard; Manske, Sarah L.; Boyd, Steven K.

doi:10.1002/jor.24410

Cited by 32 publications

(23 citation statements)

References 51 publications

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“…It can also be expected here that advances in technology and image processing may enable similar evaluation protocols in human diagnostic imaging. To further add value to the approach, the method could be tested with high-resolution peripheral quantitative CT (HRpQCT) scans for peripheral infections, since the resolution of HRpQCT (60 µm) is sufficient to monitor bone changes in fracture repair or in joint degeneration 60,61 .…”

Section: Discussionmentioning

confidence: 99%

Longitudinal time-lapse in vivo micro-CT reveals differential patterns of peri-implant bone changes after subclinical bacterial infection in a rat model

Stadelmann

Thompson

Zeiter

et al. 2020

Sci Rep

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Subclinical infection associated with orthopedic devices can be challenging to diagnose. The goal of this study was to evaluate longitudinal, microcomputed tomography (microCT) imaging in a rat model of subclinical orthopedic device-related infection caused by Staphylococcus epidermidis and four different Cutibacterium (previously Propionibacterium) acnes strains, and compare outcomes with non-inoculated and historical S. aureus-inoculated controls. Sterile screws or screws colonized with bacteria were placed in the tibia of 38 adult Wistar rats [n = 6 sterile screws; n = 6 S. epidermidis-colonized screws; n = 26 C. acnes-colonized screws (covering all three main subspecies)]. Regular microCT scans were taken over 28 days and processed for quantitative time-lapse imaging with dynamic histomorphometry. At euthanasia, tissues were processed for semiquantitative histopathology or quantitative bacteriology. All rats receiving sterile screws were culture-negative at euthanasia and displayed progressive bony encapsulation of the screw. All rats inoculated with S. epidermidis-colonized screws were culture-positive and displayed minor changes in peri-implant bone, characteristic of subclinical infection. Five of the 17 rats in the C. acnes inoculated group were culture positive at euthanasia and displayed bone changes at the interface of the screw and bone, but not deeper in the peri-implant bone. Dynamic histomorphometry revealed significant differences in osseointegration, bone remodeling and periosteal reactions between groups that were not measurable by visual observation of still microCT images. Our study illustrates the added value of merging 3D microCT data from subsequent timepoints and producing inherently richer 4D data for the detection and characterization of subclinical orthopedic infections, whilst also reducing animal use.

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Section: Discussionmentioning

confidence: 99%

Longitudinal time-lapse in vivo micro-CT reveals differential patterns of peri-implant bone changes after subclinical bacterial infection in a rat model

Stadelmann

Thompson

Zeiter

et al. 2020

Sci Rep

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“…Prior clinical studies have demonstrated a compartment/region-dependent loss of periarticular bone mass and/or bone mineral density following traumatic joint injury 37-42 . Several of these studies indicate incomplete recovery of bony deficits in the long-term, with some evidence even indicating lower BMD in the injured limb 10+ years after knee injury.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Joint Injury Induces Acute Catabolic Bone Turnover Concurrent with Articular Cartilage Damage in a Rat Model of Post-Traumatic Osteoarthritis

Maerz

Newton

Fleischer

et al. 2020

Preprint

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24Objective: Assess acute alterations in bone turnover, microstructure, and histomorphometry following 25 noninvasive anterior cruciate ligament rupture (ACLR). 26Methods: Twelve female Lewis rats were randomized to receive noninvasive ACLR or Sham loading 27 (n=6/group). In vivo μCT was performed at 3, 7, 10, and 14 days post-injury to quantify compartment-28 dependent subchondral (SCB) and epiphyseal trabecular bone remodeling. Near-infrared (NIR) molecular 29imaging was used to measure in vivo bone anabolism (800 CW BoneTag) and catabolism (Cat K 680 30 FAST). Metaphyseal bone remodeling and articular cartilage morphology was quantified using ex vivo 31 μCT and contrast-enhanced µCT, respectively. Calcein-based dynamic histomorphometry was used to 32 quantify bone formation. OARSI scoring was used to assess joint degeneration, and osteoclast number 33 was quantified on TRAP stained-sections. 34Results: ACLR induced acute catabolic bone remodeling in subchondral, epiphyseal, and metaphyseal 35 compartments. Thinning of medial femoral condyle (MFC) SCB was observed as early as 7 days post-36 injury, while lateral femoral condyles (LFC) exhibited SCB gains. Trabecular thinning was observed in 37 MFC epiphyseal bone, with minimal changes to LFC. NIR imaging demonstrated immediate and 38 sustained reduction of bone anabolism (~15-20%), and a ~32% increase in bone catabolism at 14 days, 39 compared to contralateral limbs. These findings were corroborated by reduced bone formation rate and 40 increased osteoclast numbers, observed histologically. ACLR-injured femora had significantly elevated 41 OARSI score, cartilage thickness, and cartilage surface deviation. 42 Conclusion: ACL rupture induces immediate and sustained reduction of bone anabolism and 43 overactivation of bone catabolism, with mild-to-moderate articular cartilage damage at 14 days post-44 injury. 45 46 47 INTRODUCTION: 48 Post-traumatic osteoarthritis (PTOA) is a degenerative joint condition known to develop 49 following traumatic joint injuries. Anterior cruciate ligament (ACL) rupture is associated with a 50 particularly high risk for PTOA developmentapproximately 50% of patients develop PTOA 51 10-15 years after ACL rupture 1-3 . Surgical ACL reconstruction is a successful treatment to 52 alleviate pain and restore joint stability and function, but despite excellent patient-reported 53 outcomes and a high return-to-sport incidence, reconstruction has not been definitively shown to 54 alter the natural history of PTOA 2, 4, 5 . This observation has led to the hypothesis that acute 55 biological events initiated post-injury play a key role in the onset and progression of PTOA, as 56 opposed to primarily chronic joint instability. These biological events, their respective 57 contribution to PTOA pathogenesis, and the mechanisms that regulate them remain poorly 58 understood. 59 Crosstalk between articular cartilage (AC) and bone is an important component of 60 healthy joint homeostasis. AC and underlying bone interact via biochemical and mechanical 61...

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“…performed and analyzed all scans using the standard manufacturer’s method 7 for the primary morphological parameters described here. 33…”

Section: Methodsmentioning

confidence: 99%

“…8,22,25,26 In addition, BMD changes and subchondral bone changes have been observed after full ACL rupture in human studies. 33,55,57…”

mentioning

confidence: 99%

Structural Consequences of a Partial Anterior Cruciate Ligament Injury on Remaining Joint Integrity: Evidence for Ligament and Bone Changes Over Time in an Ovine Model

et al. 2021

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Background: Severe injury to the knee joint often results in accelerated posttraumatic osteoarthritis (PTOA). In an ovine knee injury model, altered kinematics and degradation of the cartilage have been observed at 20 and 40 weeks after partial anterior cruciate ligament (ACL) transection (p-ACL Tx) surgery. However, changes to the integrity of the remaining intact intra-articular ligaments (posterolateral [PL] band and posterior cruciate ligament [PCL]) as well as the subchondral bone after anteromedial (AM) band Tx remain to be characterized. Purpose: (1) To investigate histological alterations to the remaining intact intra-articular ligaments, the synovium, and the infrapatellar fat pad (IPFP) and (2) to quantify subchondral bone changes at the contact surfaces of the proximal tibia at 20 and 40 weeks after AM band Tx. Study Design: Descriptive laboratory study. Methods: Mature female Suffolk cross sheep were allocated into 3 groups: nonoperative controls (n = 6), 20 weeks after partial ACL transection (p-ACL Tx; n = 5), and 40 weeks after p-ACL Tx (n = 6). Ligament, synovium, and IPFP sections were stained and graded. Tibial subchondral bone microarchitecture was assessed using high-resolution peripheral quantitative computed tomography. Results: p-ACL Tx of the AM band led to significant change in histological scores of the PL band and the PCL at 20 weeks after p-ACL Tx ( P = .031 and P = .033, respectively) and 40 weeks after p-ACL Tx ( P = .011 and P = .029) as compared with nonoperative controls. Alterations in inflammatory cells and collagen fiber orientation contributed to the greatest extent of the combined histological score in the PL band and PCL. p-ACL Tx did not lead to chronic activation of the synovium or IPFP. Trabecular bone mineral density was strongly inversely correlated with combined gross morphological damage in the top and middle layers of the subchondral bone in the lateral tibial plateau for animals at 40 weeks after p-ACL Tx. Conclusion: p-ACL Tx influences the integrity (biology and structure) of remaining intact intra-articular ligaments and bone microarchitecture in a partial knee injury ovine model. Clinical Relevance: p-ACL Tx leads to alterations in structural integrity of the remaining intact ligaments and degenerative changes in the trabecular bone mineral density, which may be detrimental to the injured athlete’s knee joint in the long term.

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Longitudinal Effects of Acute Anterior Cruciate Ligament Tears on Peri‐Articular Bone in Human Knees Within the First Year of Injury

Cited by 32 publications

References 51 publications

Longitudinal time-lapse in vivo micro-CT reveals differential patterns of peri-implant bone changes after subclinical bacterial infection in a rat model

Longitudinal time-lapse in vivo micro-CT reveals differential patterns of peri-implant bone changes after subclinical bacterial infection in a rat model

Traumatic Joint Injury Induces Acute Catabolic Bone Turnover Concurrent with Articular Cartilage Damage in a Rat Model of Post-Traumatic Osteoarthritis

Structural Consequences of a Partial Anterior Cruciate Ligament Injury on Remaining Joint Integrity: Evidence for Ligament and Bone Changes Over Time in an Ovine Model

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