Harkey Matthew S, Grozier Corey D, Tolzman Jessica, Parmar Arjun, Fagan Molly, Collins Katherine, Kuenze Christopher, Fajardo Ryan
Michigan State University, 308W. Circle Drive 112, East Lansing 48824, MI, United States.
Grand Valley State University, United States.
Osteoarthr Imaging. 2024 Mar;4(1). doi: 10.1016/j.ostima.2024.100175. Epub 2024 Feb 9.
Chronic inflammation and altered walking biomechanics are common after ACL reconstruction (ACLR) and contribute to the development of osteoarthritis. Clinically accessible techniques are needed to monitor inflammation (ultrasound-assessed effusion-synovitis) and walking biomechanics (force-measuring insoles), and they must improve the translation of these assessments and determine whether inflammation and walking biomechanics are related in patients after ACLR. This study aimed to determine the association between ultrasound-detected knee effusion-synovitis and limb loading asymmetries during walking in patients 1-5 years post-ACLR.
15 participants (9 women; age: 26 ± 6yrs; mass: 71 ± 15 kg; height: 173 ± 9 cm; months post-ACLR: 29 ± 13) were included in this cross-sectional study. Knee effusion-synovitis was assessed using a standardized protocol and graded using a validated scoring atlas (0 = absent, 1 = mild, 2 = moderate, 3 = severe) in the ACLR limb. Force-measuring insoles were used to capture the vertical ground reaction force (vGRF) during a one-minute treadmill walking trial. Limb symmetry indices (LSIs) were used to quantify limb loading asymmetry for the peak vGRF and the instantaneous loading rate (vGRF-LR). Spearman correlations determined whether effusion-synovitis grade was associated with peak vGRF and vGRF-LR LSI.
Effusion-synovitis was present in the ACLR limb of 13/15 (87 %) participants (Grade 0: = 2; Grade 1: = 8; Grade 2: = 4, Grade 3: = 1). Effusion-synovitis grade was not significantly associated with peak vGRF LSI (mean±sd: 98.0 ± 5.6; ρ = 0.38, = 0.162), but was significantly associated with vGRF-LR LSI (98.2 ± 11.4; ρ = 0.55, = 0.035).
Most participants 1-5 years post-ACLR have ultrasound-detected effusion-synovitis. Participants with more severe effusion-synovitis load their ACLR limb more rapidly. This study highlights the utility of clinically accessible techniques in assessing inflammation and walking biomechanics in ACLR patients.
前交叉韧带重建术（ACLR）后慢性炎症和行走生物力学改变很常见，并会导致骨关节炎的发展。需要临床可用的技术来监测炎症（超声评估的积液 - 滑膜炎）和行走生物力学（测力鞋垫），并且这些技术必须改善这些评估的转化应用，并确定ACLR术后患者的炎症与行走生物力学是否相关。本研究旨在确定ACLR术后1至5年患者超声检测到的膝关节积液 - 滑膜炎与行走时肢体负荷不对称之间的关联。
本横断面研究纳入了15名参与者（9名女性；年龄：26±6岁；体重：71±15千克；身高：173±9厘米；ACLR术后月数：29±13）。采用标准化方案评估ACLR肢体的膝关节积液 - 滑膜炎，并使用经过验证的评分图谱进行分级（0 = 无，1 = 轻度，2 = 中度，3 = 重度）。在一分钟的跑步机行走试验中，使用测力鞋垫采集垂直地面反作用力（vGRF）。肢体对称指数（LSIs）用于量化峰值vGRF和瞬时负荷率（vGRF - LR）的肢体负荷不对称性。Spearman相关性分析确定积液 - 滑膜炎分级是否与峰值vGRF和vGRF - LR LSI相关。
13/15（87%）的参与者ACLR肢体存在积液 - 滑膜炎（0级：2例；1级：8例；2级：4例；3级：1例）。积液 - 滑膜炎分级与峰值vGRF LSI无显著相关性（平均值±标准差：98.0±5.6；ρ = 0.38，P = 0.162），但与vGRF - LR LSI显著相关（98.2±11.4；ρ = 0.55，P = 0.035）。
大多数ACLR术后1至5年的参与者存在超声检测到的积液 - 滑膜炎。积液 - 滑膜炎更严重的参与者其ACLR肢体负荷速度更快。本研究强调了临床可用技术在评估ACLR患者炎症和行走生物力学方面的实用性。
