Abstract
Background: Anterior cruciate ligament (ACL) tear represents a common orthopedic traumatic issue that often leads to an early development of osteoarthritis. To improve the diagnostic and prognostic techniques involved in the assessment of the joint after the trauma and during the healing process, the present work proposes a multi-parametric approach that aims to investigate the relationship between joint function and soft tissue status before and after ACL reconstruction. Methods: Thirteen consecutive patients who underwent ACL reconstruction were preliminarily enrolled in this study. Joint laxity assessment as well as magnetic resonance imaging with T2 mapping were performed in the pre-operative stage, at four and 18 months after surgery to acquire objective information to correlate knee function and soft tissue condition. Results: Correlations were found between graft and cartilage T2 signal, suggesting an interplay between these tissues within the knee joint. Moreover, graft maturation resulted in being connected to joint laxity, as underlined by the correlation between the graft T2 signal and the temporal evolution of knee function. Conclusions: This preliminary study represents a step forward in assessing the effects of ACL graft maturation on knee biomechanics, and vice versa. The presented integrated framework underlines the possibility to quantitatively assess the impact of ACL reconstruction on trauma recovery and cartilage homeostasis. Moreover, the reported findings—despite the preliminary nature of the clinical impacts—evidence the possibility of monitoring the surgery outcomes using a multi-parametric prognostic investigation tool.
Highlights
Anterior cruciate ligament (ACL) tears represent one of the most critical issues affecting the human knee [1]; ACL injuries significantly impair joint biomechanics by increasing knee laxity in both the frontal and transverse plane [2,3]
No statistically significant correlation was found between joint laxity and the subjects’ demographic data
The present pilot study aimed at promoting the use of a comprehensive methodological multi-parametric approach capable of quantifying the relationships between the status of the soft tissues within the knee joint and its biomechanical condition, which are important in the assessment of both the trauma and the effects of the reconstruction
Summary
Anterior cruciate ligament (ACL) tears represent one of the most critical issues affecting the human knee [1]; ACL injuries significantly impair joint biomechanics by increasing knee laxity in both the frontal and transverse plane [2,3]. Common reconstructive techniques imply the substitution of the injured ligament by using a biological graft to restore knee function with good clinical outcomes [4]. Even though this kind of treatment has substantially been improved over time, the optimal approach is still a challenging issue in orthopedic research and clinical practice [5]. To assess the knee status after ACL tear and following reconstruction, one of the most widely used, non-invasive, and predictive method is represented by magnetic resonance imaging (MRI) [9,10,11], which allows a structural integrity observation of both cartilage and graft. The reported findings—despite the preliminary nature of the clinical impacts—evidence the possibility of monitoring the surgery outcomes using a multi-parametric prognostic investigation tool
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