Patients With Abnormal Limb Kinetics at 6 Months After Anterior Cruciate Ligament Reconstruction Have an Increased Risk of Persistent Medial Meniscal Abnormality at 3 Years

Author:

Shimizu Tomohiro123,Markes Alexander R.1,Samaan Michael A.24,Tanaka Matthew S.2,Souza Richard B.25,Li Xiaojuan26,Ma C. Benjamin1

Affiliation:

1. Department of Orthopaedic Surgery, University of California, San Francisco, California, USA.

2. Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA.

3. Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan.

4. Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA.

5. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, California, USA.

6. Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, Ohio, USA.

Abstract

Background: Several reports have shown that altered biomechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of posttraumatic osteoarthritis. However, it is not fully understood whether altered biomechanics are associated with meniscal changes after ACLR. Purpose: To investigate changes in gait and landing biomechanics over a 3-year period and their correlation with meniscal matrix alterations present before and after ACLR through use of magnetic resonance T1ρ/T2 mapping, which can allow detection of early meniscal degeneration. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 36 patients with ACLR and 14 healthy controls were included in this study. All patients underwent magnetic resonance imaging and biomechanical analysis during gait of the injured knee and contralateral knee preoperatively and at 6 months, 1 year, 2 years, and 3 years after ACLR, as well as biomechanical analysis during drop-landing from 6 months to 3 years postoperatively. To evaluate biochemical changes of the mensical matrix, T1ρ/T2 relaxation times of the meniscus were calculated. Results: Mean T1ρ/T2 values of ACLR knees were significantly higher than values in the contralateral and control knees in the posterior lateral and medial horns up to 1 year after surgery; however, the differences were not seen at 3 years after surgery. The ACLR knee exhibited significantly lower peak knee flexion moment and angle during gait at 6 months compared with baseline and continued to decrease until 3 years. The ACLR knee exhibited significantly lower peak vertical ground-reaction force and peak knee flexion moment and angle during landing at 6 months. However, the differences were no longer present at 3 years. Biomechanics at 6 months had significant correlations with changes of mean T1ρ/T2 values in the medial posterior horn from 6 months to 3 years after ACLR. Conclusion: Although mean T1ρ/T2 values of meniscus seen before ACLR improved after 3 years, approximately 30% of patients with ACLR did not show decreases from 6 months to 3 years. Patients with abnormal lower limb kinetics of the ACLR knee at 6 months showed less recovery in the medial posterior horn from 6 months to 3 years, suggesting that biomechanical parameters during the early stage of recovery might be potential biomarkers for predicting persistent medial meniscal abnormality after ACLR.

Publisher

SAGE Publications

Subject

Orthopedics and Sports Medicine

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