Longitudinal changes in adiposity following anterior cruciate ligament reconstruction and associations with knee symptoms and function

Amélie Michaud; Chris Koskoletos; Brooke E Patterson; Kay M Crossley; Trevor B Birmingham; Adam G Culvenor; Harvi F Hart

doi:10.1016/j.ocarto.2024.100473

Longitudinal changes in adiposity following anterior cruciate ligament reconstruction and associations with knee symptoms and function

Osteoarthr Cartil Open. 2024 Apr 25;6(2):100473. doi: 10.1016/j.ocarto.2024.100473. eCollection 2024 Jun.

Authors

Amélie Michaud^{1

2}, Chris Koskoletos^{3

2}, Brooke E Patterson⁴, Kay M Crossley⁴, Trevor B Birmingham², Adam G Culvenor⁴, Harvi F Hart^{4

2}

Affiliations

¹ Action Sport Physio, Sherbrooke, Canada.
² School of Physical Therapy, Western University, London, Canada.
³ Rewind Physio, Embrun, Ontario, Canada.
⁴ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.

Abstract

Objective: To evaluate adiposity after anterior cruciate ligament reconstruction (ACLR): i) cross-sectionally (1-year post-ACLR) compared to uninjured controls; ii) longitudinally up to 5 years post-ACLR; and iii) associations with patient-reported symptoms and physical performance.

Methods: In 107 individuals post-ACLR and 19 controls, we assessed global (BMI), peripheral (subcutaneous adipose tissue thickness on the posteromedial side of knee MRI), and central (waist circumference in ACLR group) adiposity. Patient-reported symptoms (Knee injury and Osteoarthritis Outcome Score) and physical performance (hop for distance) were evaluated at 1 and 5 years post-ACLR. Linear regression models evaluated adiposity between groups. Paired t-tests evaluated changes in adiposity from 1- to 5 years post-ACLR. Linear regression models analyzed adiposity's associations with patient-reported symptoms and physical performance at 1-year post-ACLR, changes in symptoms and performance over 4 years post-ACLR, and longitudinal changes in adiposity and symptoms and performance, controlling for age, sex, and activity level.

Results: Individuals 1-year post-ACLR were associated with higher average global (3 kg/m²) and peripheral adiposity (2.3 mm). From 1- to 5 years post-ACLR, higher average global (0.58 kg/m²) and central (5 cm) adiposity, and lower average peripheral adiposity (1.3 mm) were observed. In general, adiposity at one-year post-ACLR was negatively associated with patient-reported symptoms and physical performance, and changes from 1 to 5 years post-ACLR. Increases in adiposity were negatively associated with changes in patient-reported symptoms and physical performance over four years post-ACLR.

Conclusion: Greater global and central adiposity is a feature of young adults following ACLR and influences current and future patient-reported symptoms and physical performance.

Keywords: Hop distance; Knee adiposity; Pain; Rehabilitation; Subcutaneous fat; Waist circumference.