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Author Spotlight: Investigating Early Events and Long-Term Effects of ACL Injuries for Osteoarthritis Progression
Published on: September 29, 2023
Bone shape changes over two years following acute anterior cruciate ligament injury: Reconstructed vs
L Hassanlou1, M A Bowes2, A Turkiewicz3
1Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Finland.
Objective:
To determine bone shape changes over two years after acute anterior cruciate ligament (ACL) injury and to compare knees treated with ACL reconstruction (ACLR) vs no ACLR.
Design:
We used prospective data involving 129 young adults (46 % female, mean age 25 years) with recent ACL injury from a subcohort within the prospective multicenter NACOX study. Patients were treated according to Swedish guidelines with supervised rehabilitation before considering ACLR. 3D MR images obtained at baseline, 3-, 6-, 12, and 24-months post-injury were assessed for changes in the femur and tibia bone surface area using active appearance models. We used a linear mixed-effects model adjusted for age, sex, body mass index, and pre-injury Tegner physical activity level.
Results:
We observed growth in bone areas over the first two years, particularly in the medial femur and medial tibia, with an average relative increase of 1.28 % (95 % CI 0.67 %, 1.88 %) and 1.04 % (0.44 %, 1.65 %), respectively. The lateral femur also showed growth, with an increase of 1.15 % (0.55 %, 1.75 %). We found little differences comparing ACLR patients to non-ACLR patients, adjusted relative percentage differences: medial femur, 0.01 % (95 % CI: 0.9 %, 1.1 %); medial tibia, -0.03 % (-1.2 %, 0.7 %); lateral femur, 0.04 % (-0.6 %, 1.4 %); and lateral tibia, -0.11 % (-2.1 %, -0.1 %).
Conclusion:
After acute ACL injury, there is a growth primarily in the medial femoral and tibial condyles. The bone shape changes could hypothetically be a response to altered biomechanical conditions and may precede the development of knee OA.
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