Centre for Hip Health and Mobility, Vancouver, Canada.
Clinician Investigator Program, University of British Columbia, Vancouver, Canada.
Bone Joint J. 2021 Sep;103-B(9):1505-1513. doi: 10.1302/0301-620X.103B9.BJJ-2020-1955.R1.
Anterior cruciate ligament (ACL) rupture commonly leads to post-traumatic osteoarthritis, regardless of surgical reconstruction. This study uses standing MRI to investigate changes in contact area, contact centroid location, and tibiofemoral alignment between ACL-injured knees and healthy controls, to examine the effect of ACL reconstruction on these parameters.
An upright, open MRI was used to directly measure tibiofemoral contact area, centroid location, and alignment in 18 individuals with unilateral ACL rupture within the last five years. Eight participants had been treated nonoperatively and ten had ACL reconstruction performed within one year of injury. All participants were high-functioning and had returned to sport or recreational activities. Healthy contralateral knees served as controls. Participants were imaged in a standing posture with knees fully extended.
Participants' mean age was 28.4 years (SD 7.3), the mean time since injury was 2.7 years (SD 1.6), and the mean International Knee Documentation Subjective Knee Form score was 84.4 (SD 13.5). ACL injury was associated with a 10% increase (p = 0.001) in contact area, controlling for compartment, sex, posture, age, body mass, and time since injury. ACL injury was associated with a 5.2% more posteriorly translated medial centroid (p = 0.001), equivalent to a 2.6 mm posterior translation on a representative tibia with mean posteroanterior width of 49.4 mm. Relative to the femur, the tibiae of ACL ruptured knees were 2.3 mm more anteriorly translated (p = 0.003) and 2.6° less externally rotated (p = 0.010) than healthy controls. ACL reconstruction was not associated with an improvement in any measure.
ACL rupture was associated with an increased contact area, posteriorly translated medial centroid, anterior tibial translation, and reduced tibial external rotation in full extension. These changes were present 2.7 years post-injury regardless of ACL reconstruction status. Cite this article: 2021;103-B(9):1505-1513.
前交叉韧带（ACL）撕裂通常会导致创伤后骨关节炎，无论是否进行手术重建。本研究使用站立 MRI 来研究 ACL 损伤膝关节与健康对照组之间的接触面积、接触中心点位置和胫股对线的变化，以检查 ACL 重建对这些参数的影响。
使用直立式开放式 MRI 直接测量 18 名 ACL 撕裂患者的患侧膝关节和 8 名未接受手术治疗患者的对侧膝关节以及 10 名 ACL 重建患者的患侧膝关节在过去五年内的胫股接触面积、中心点位置和对线。所有参与者均为高功能状态，已恢复运动或娱乐活动。健康的对侧膝关节作为对照组。参与者在膝关节完全伸展的站立姿势下进行成像。
参与者的平均年龄为 28.4 岁（标准差 7.3），受伤后平均时间为 2.7 年（标准差 1.6），国际膝关节文献委员会主观膝关节评分平均为 84.4（标准差 13.5）。控制节段、性别、姿势、年龄、体重和受伤后时间后，ACL 损伤与接触面积增加 10%相关（p = 0.001）。ACL 损伤与内侧中心点向后平移 5.2%相关（p = 0.001），相当于在具有平均前后宽度 49.4mm 的代表性胫骨上向后平移 2.6mm。与股骨相比，ACL 撕裂膝关节的胫骨向前平移 2.3mm（p = 0.003），外旋减少 2.6°（p = 0.010）。ACL 重建与任何测量值的改善均无关。
ACL 撕裂与完全伸展时接触面积增加、内侧中心点向后平移、胫骨向前平移和胫骨外旋减少有关。这些变化在受伤后 2.7 年时仍然存在，无论 ACL 重建状态如何。引用本文：2021;103-B（9）：1505-1513。
