Abstract
BackgroundAnterior cruciate ligaments (ACL) injuries represent a major risk factor for early osteoarthritis (OA).PurposeTo evaluate the prevalence and 4-year progression of knee OA measured with 3T MR-imaging in individuals with ruptured, reconstructed or normal ACL and to assess the impact of thigh muscle characteristics.MethodsA total of 54 knees (23/54 male, 31/54 female) were recruited from the Osteoarthritis Initiative (OAI). At baseline, 15/54 subjects had prevalent ACL ruptures and 15/54 subjects had prevalent ACL reconstruction (24/54 normal ACL). Western Ontario and McMasters Universities Arthritis Index (WOMAC) scores, Physical Activity Scores of the Elderly (PASE) and thigh muscle characteristics including strength, fat infiltration (Goutallier score) and thigh muscle cross-sectional area (CSA) MR measurements were obtained at baseline. Whole-organ MR-imaging Scores (WORMS) were obtained at baseline and at a 4-year follow-up time-point. Multivariate regression models, adjusting for covariates (age, gender, body mass index), were used for statistical analysis.ResultsAt baseline, subjects with prevalent ACL ruptures had worse WORMS total scores (mean±SEM, 44.1±3.5) than subjects with ACL reconstruction (30.8±4.0; P = 0.015) and worse than subjects with normal ACL (21.3±3.0; P<0.001). Cartilage scores were worse in both femorotibial compartments in ACL injured knees than in knees with normal ACL (P<0.05). Knees with ACL reconstruction showed an increased degeneration of the medial meniscus (P = 0.036), cartilage degeneration at the medial femoral condyle (P = 0.011). In a multivariate regression model, including both ACL groups and total muscle characteristics as influence parameters, high thigh muscle CSA, high muscle/ fat ratio and low Goutallier scores were associated with less degenerative changes at the knee, independent of ACL status. Knees with ACL reconstruction showed an increased progression of cartilage degeneration at the medial tibia compared to the normal ACL group (P = 0.027).ConclusionsHigh thigh muscle CSA is associated with less degenerative changes at the knee, independent of the ACL status and may potentially be advantageous in the prevention of early OA.
Highlights
Anterior cruciate ligament (ACL) ruptures are associated with an increased risk for post-traumatic osteoarthritis (OA) [1, 2]
The Osteoarthritis Initiative (OAI) is a publicprivate partnership comprised of five contracts (N01-AR-2-2258; N01-AR-2-2259; N01-AR-22260; N01-AR-2-2261; N01-AR-2-2262) funded by the National Institutes of Health, a branch of the Department of Health and Human Services, and conducted by the OAI Study Investigators
The analyses in this study were funded through the NIH (National Institute of Arthritis and Musculoskeletal and Skin Diseases grants R01AR064771 and P50AR060752)
Summary
Anterior cruciate ligament (ACL) ruptures are associated with an increased risk for post-traumatic osteoarthritis (OA) [1, 2]. To prevent early OA, in approximately two-thirds of patients with ACL ruptures, treatment consists of ACL reconstruction, aiming to restore mechanical stability [2, 4, 5]. Muscle characteristics of the thigh and knee joint degeneration may be determined quantitatively or semi-quantitatively using MR imaging. Many studies evaluate outcome after ACL reconstruction, no MR imaging study evaluates the impact of ACL status and thigh muscle characteristics on the longitudinal progression of degenerative changes at the knee [19]. To evaluate the prevalence and 4-year progression of knee OA measured with 3T MR-imaging in individuals with ruptured, reconstructed or normal ACL and to assess the impact of thigh muscle characteristics
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