Georgetown University School of Medicine, Washington, DC.
MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
J Athl Train. 2021 Nov 1;56(11):1173-1179. doi: 10.4085/1062-6050-0458.20.
Hypertrophy of the infrapatellar fat pad (IFP) in idiopathic knee osteoarthritis has been linked to deleterious synovial changes and joint pain related to mechanical tissue impingement. Yet little is known regarding the IFP's volumetric changes after anterior cruciate ligament reconstruction (ACLR).
To examine changes in IFP volume between 6 and 12 months after ACLR and determine associations between patient-reported outcomes and IFP volume at each time point as well as the volume change over time. In a subset of individuals, we examined interlimb IFP volume differences 12 months post-ACLR.
Prospective cohort study.
Laboratory.
We studied 26 participants (13 women, 13 men, age = 21.88 ± 3.58 years, body mass index = 23.82 ± 2.21 kg/m2) for our primary aims and 13 of those participants (8 women, 5 men, age = 21.15 ± 3.85 years, body mass index = 23.01 ± 2.01 kg/m2) for our exploratory aim.
MAIN OUTCOME MEASURE(S): Using magnetic resonance imaging, we evaluated the IFP volume change between 6 and 12 months post-ACLR in the ACLR limb and between-limbs differences at 12 months in a subset of participants. International Knee Documentation Committee subjective knee evaluation (IKDC) scores were collected at 6-month and 12-month follow-ups, and associations between IFP volume and patient-reported outcomes were determined.
The IFP volume in the ACLR limb increased from 6 months (19.67 ± 6.30 cm3) to 12 months (21.26 ± 6.91 cm3) post-ACLR. Greater increases of IFP volume between 6 and 12 months were significantly associated with better 6-month IKDC scores (r = .44, P = .03). The IFP volume was greater in the uninjured limb (22.71 ± 7.87 cm3) than in the ACLR limb (20.75 ± 9.03 cm3) 12 months post-ACLR.
The IFP volume increased between 6 and 12 months post-ACLR; however, the IFP volume of the ACLR limb remained smaller than that of the uninjured limb at 12 months. In addition, those with better knee function 6 months post-ACLR demonstrated greater increases in IFP volume between 6 and 12 months post-ACLR. This suggests that greater IFP volumes may play a role in long-term joint health after ACLR.
特发性膝骨关节炎中髌下脂肪垫（IFP）的肥大与有害的滑膜变化以及与机械组织撞击相关的关节疼痛有关。然而，关于前交叉韧带重建（ACLR）后 IFP 体积的变化知之甚少。
检查 ACLR 后 6 至 12 个月 IFP 体积的变化，并确定每个时间点患者报告的结果与 IFP 体积之间以及随时间的体积变化之间的相关性。在一些个体中，我们检查了 ACLR 后 12 个月时肢体间 IFP 体积的差异。
前瞻性队列研究。
实验室。
我们研究了 26 名参与者（13 名女性，13 名男性，年龄=21.88±3.58 岁，体重指数=23.82±2.21kg/m2）以实现我们的主要目标，以及其中的 13 名参与者（8 名女性，5 名男性，年龄=21.15±3.85 岁，体重指数=23.01±2.01kg/m2）以实现我们的探索性目标。
使用磁共振成像，我们评估了 ACLR 肢体在 ACLR 后 6 至 12 个月之间 IFP 体积的变化，以及在一些参与者中在 12 个月时肢体间的差异。在 6 个月和 12 个月的随访中收集国际膝关节文献委员会主观膝关节评估（IKDC）评分，并确定 IFP 体积与患者报告结果之间的相关性。
ACL 肢体的 IFP 体积从 ACLR 后 6 个月（19.67±6.30cm3）增加到 12 个月（21.26±6.91cm3）。6 至 12 个月之间 IFP 体积的较大增加与 6 个月时更好的 IKDC 评分显著相关（r=0.44，P=0.03）。ACL 肢体的 IFP 体积在 ACLR 后 12 个月时小于未受伤肢体的 IFP 体积（22.71±7.87cm3）。
IFP 体积在 ACLR 后 6 至 12 个月之间增加；然而，在 12 个月时，ACL 肢体的 IFP 体积仍小于未受伤肢体的 IFP 体积。此外，ACLR 后 6 个月膝关节功能较好的患者，在 ACLR 后 6 至 12 个月之间 IFP 体积的增加更大。这表明更大的 IFP 体积可能在 ACLR 后长期关节健康中起作用。
