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» Articles » PMID: 33528592

Development of New Cartilage Lesions After ACL Reconstruction is Associated with Abnormal Knee Rotation

Overview
Journal Knee Surg Sports Traumatol Arthrosc
Publisher Wiley
Specialties Emergency Medicine
General Surgery
Orthopedics
Date 2021 Feb 2
PMID 33528592
Citations 6
Authors
F Zampeli
E Pappas
G Velonakis
I M Roumpelakis
L S Poulou
G I Papagiannis
A D Kelekis
D S Mastrokalos
Affiliations
Soon will be listed here.
Abstract

Purpose: The purpose of this study is to examine the association between the development of articular cartilage pathology and knee rotation after single-bundle anterior cruciate ligament (ACL) reconstruction.

Methods: Seventeen patients that underwent single-bundle ACL reconstruction and did not have any cartilage lesions at the time of surgery based on the Outerbridge classification or meniscal injury that required meniscectomy > 20% were examined by MRI and in the biomechanics laboratory at a 6-year minimum follow-up. Cartilage lesions that occurred after reconstruction were graded on MRI according to a modified Noyes scale. For cartilage evaluation, the lateral and medial femoral condyles were divided into 9 segments each (lateral, central, and medial third and each third was divided into anterior, central, and posterior segment). Tibial rotation during a pivoting task was measured with optoelectronic motion analysis system and side-to-side differences of tibial rotation between the reconstructed and contralateral intact knees were calculated. The association between the total modified Noyes scale score (outcome variable) and side-to-side differences of tibial rotation after controlling for meniscectomy and meniscal repair was investigated with hierarchical regression models.

Results: Side-to-side difference of tibial rotation was associated with total modified Noyes scale score (p = 0.015, β = 0.667, adjusted R = 42.1%). All patients developed new cartilage lesions in MRI located mainly at the central region of the lateral femoral condyle and less frequently in the central and anterior regions of the medial femoral condyle.

Conclusion: Abnormally increased tibial rotation that persists after ACL-R is significantly associated with the development of new articular cartilage lesions at mean 8.4 years after reconstruction which were located mainly at the central region of the LFC and secondarily in the central and anterior regions of the MFC (more superficial lesions). These findings suggest that there is emerging evidence that abnormal rotational kinematics is a potential risk factor for the pathogenesis and onset of posttraumatic articular cartilage degeneration after ACLR.

Level Of Evidence: IV.

Citing Articles

Chronic ACLD Knees with Early Developmental Cartilage Lesions Exhibited Increased Posterior Tibial Translation during Level Walking.

Zeng X, Lin F, Huang W, Kong L, Zeng J, Guo D Orthop Surg. 2024; 16(6):1364-1373.

PMID: 38693612 PMC: 11144518. DOI: 10.1111/os.14072.

Risk factors of cartilage lesion after anterior cruciate ligament reconstruction.

Huang Z, Cui J, Zhong M, Deng Z, Chen K, Zhu W Front Cell Dev Biol. 2022; 10:935795.

PMID: 36158222 PMC: 9498578. DOI: 10.3389/fcell.2022.935795.

Knee Kinematic Patterns and Early Cartilage Lesion Characteristics in Patients with Anterior Cruciate Ligament Reconstruction.

Zeng X, Zeng J, Lin J, Kong L, Chen H, Zhong G J Clin Med. 2022; 11(18).

PMID: 36143105 PMC: 9506078. DOI: 10.3390/jcm11185457.

ACLD patients exhibit additional knee kinematic asymmetries at the speed level of healthy subjects.

Kong L, Yang T, Wang Q, Ou Y, Huang H, Huang W Front Bioeng Biotechnol. 2022; 10:930722.

PMID: 36082158 PMC: 9445214. DOI: 10.3389/fbioe.2022.930722.

Adjustable-loop implants are non-inferior to fixed-loop implants for femoral fixation in anterior cruciate ligament reconstruction.

Elmholt S, Nielsen T, Lind M Knee Surg Sports Traumatol Arthrosc. 2022; 31(5):1723-1732.

PMID: 35737010 DOI: 10.1007/s00167-022-07034-y.

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