Persistent underloading of patellofemoral joint following hamstring autograft ACL reconstruction is associated with cartilage health

Tzu-Chieh Liao; Alyssa Bird; Michael A Samaan; Valentina Pedoia; Sharmila Majumdar; Richard B Souza

doi:10.1016/j.joca.2023.04.010

Persistent underloading of patellofemoral joint following hamstring autograft ACL reconstruction is associated with cartilage health

Osteoarthritis Cartilage. 2023 Sep;31(9):1265-1273. doi: 10.1016/j.joca.2023.04.010. Epub 2023 Apr 26.

Authors

Tzu-Chieh Liao¹, Alyssa Bird², Michael A Samaan³, Valentina Pedoia⁴, Sharmila Majumdar⁴, Richard B Souza⁵

Affiliations

¹ Department of Physical Therapy, University of Michigan-Flint, Flint, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA. Electronic address: jenliao@umich.edu.
² Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA.
³ Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA.
⁴ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.
⁵ Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.

PMID: 37116856
DOI: 10.1016/j.joca.2023.04.010

Abstract

Objective: To determine the longitudinal changes of patellofemoral joint (PFJ) contact pressure following anterior cruciate ligament reconstruction (ACLR). To identify the associations between PFJ contact pressure and cartilage health.

Design: Forty-nine subjects with hamstring autograft ACLR (27 males; age 28.8 [standard deviation, 8.3] years) and 19 controls (12 males; 30.7 [4.6] years) participated. A sagittal plane musculoskeletal model was used to estimate PFJ contact pressure. A combined T_1ρ/T₂ magnetic resonance sequence was obtained. Assessments were performed preoperatively, at 6 months, 1, 2, and 3 years postoperatively in ACLR subjects and once for controls. Repeated Analysis of Variance (ANOVA) was used to compare peak PFJ contact pressure between ACLR and contralateral knees, and t-tests to compare with control knees. Statistical parametric mapping was used to evaluate the associations between PFJ contact pressure and cartilage relaxation concurrently and longitudinally.

Results: No changes in peak PFJ contact pressure were found within ACLR knees over 3 years (preoperative to 3 years, 0.36 [CI, -0.08, 0.81] MPa), but decreased over time in the contralateral knees (0.75 [0.32, 1.18] MPa). When compared to the controls, ACLR knees exhibited lower PFJ contact pressure at all time points (at baseline, -0.64 [-1.25, -0.03] MPa). Within ACLR knees, lower PFJ contact pressure at 6 months was associated with elevated T₂ times (r = -0.47 to -0.49, p = 0.021-0.025).

Conclusions: Underloading of the PFJ following ACLR persists for up to 3 years and has concurrent and future consequences in cartilage health. The non-surgical knees exhibited normal contact pressure initially but decreased over time achieving limb symmetry.

Keywords: Anterior cruciate ligament reconstruction; Cartilage relaxation times; Contact pressure; Hamstring autograft; Osteoarthritis.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Anterior Cruciate Ligament Injuries* / surgery
Autografts
Cartilage, Articular* / surgery
Humans
Knee
Knee Joint / diagnostic imaging
Knee Joint / surgery
Magnetic Resonance Imaging
Male
Patellofemoral Joint* / diagnostic imaging

Abstract

Publication types

MeSH terms

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