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Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2-3 years following anterior cruciate ligament reconstruction.
Saxby, David John; Bryant, Adam L; Van Ginckel, Ans; Wang, Yuanyuan; Wang, Xinyang; Modenese, Luca; Gerus, Pauline; Konrath, Jason M; Fortin, Karine; Wrigley, Tim V; Bennell, Kim L; Cicuttini, Flavia M; Vertullo, Christopher; Feller, Julian A; Whitehead, Tim; Gallie, Price; Lloyd, David G.
Afiliação
  • Saxby DJ; Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia. d.saxby@griffith.edu.au.
  • Bryant AL; School of Allied Health Sciences, Griffith University, Gold Coast, Australia. d.saxby@griffith.edu.au.
  • Van Ginckel A; Gold Coast Orthopaedic Research and Education Alliance, Griffith University, Gold Coast, Australia. d.saxby@griffith.edu.au.
  • Wang Y; Room 2.05, G02, Clinical Sciences 1, Griffith University, Gold Coast Campus, Gold Coast, 4222, Australia. d.saxby@griffith.edu.au.
  • Wang X; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
  • Modenese L; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
  • Gerus P; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
  • Konrath JM; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
  • Fortin K; Department of Civil and Environmental Engineering, Imperial College London, London, UK.
  • Wrigley TV; Laboratory of Human Motion, Education and Health, University of Nice Sophia-Antipolis, Nice, France.
  • Bennell KL; Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
  • Cicuttini FM; School of Allied Health Sciences, Griffith University, Gold Coast, Australia.
  • Vertullo C; Gold Coast Orthopaedic Research and Education Alliance, Griffith University, Gold Coast, Australia.
  • Feller JA; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
  • Whitehead T; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
  • Gallie P; Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
  • Lloyd DG; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Knee Surg Sports Traumatol Arthrosc ; 27(3): 707-715, 2019 Mar.
Article em En | MEDLINE | ID: mdl-29881886
ABSTRACT

PURPOSE:

External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury.

METHODS:

This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2-3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models.

RESULTS:

In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ2(2) = 7.9, 95% confidence interval (CI) = 0.50-95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ2(2) = 4.2, 95% CI = 0.7-0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies.

CONCLUSIONS:

In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. LEVEL OF EVIDENCE IV.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Osteonecrose / Reconstrução do Ligamento Cruzado Anterior / Lesões do Ligamento Cruzado Anterior Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País/Região como assunto: Oceania Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Assunto da revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Austrália

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Osteonecrose / Reconstrução do Ligamento Cruzado Anterior / Lesões do Ligamento Cruzado Anterior Tipo de estudo: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male País/Região como assunto: Oceania Idioma: En Revista: Knee Surg Sports Traumatol Arthrosc Assunto da revista: MEDICINA ESPORTIVA / TRAUMATOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Austrália