Nilsson Henrik, Englund Martin, Frobell Richard, Lohmander L Stefan, Struglics André, Swärd Per
Department of Clinical Sciences Lund, Orthopaedics, Clinical and Molecular Osteoporosis Research Unit Faculty of Medicine Lund University Lund Sweden.
Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit Faculty of Medicine Lund University Lund Sweden.
J Exp Orthop. 2025 Jan 3;12(1):e70143. doi: 10.1002/jeo2.70143. eCollection 2025 Jan.
To investigate if hip and knee alignment assessed 2 years after anterior cruciate ligament (ACL) injury is associated with compartment-specific radiographic knee osteoarthritis (OA) 3 years later.
An exploratory analysis was conducted in the knee ACL, nonsurgical versus surgical treatment (KANON) trial (ISRCTN84752559); 115 subjects with acute ACL injury were assessed at the 2-year follow-up; full-limb images of the injured leg were acquired, and the neck-shaft angle (NSA) and hip-knee-ankle angle (HKA) were measured. At the 5-year follow-up, weight-bearing tibiofemoral and patellofemoral radiographs were obtained. Radiographs were graded according to the OA Research Society International Atlas and Radiographic OA was defined as approximating Kellgren & Lawrence grade 2 or worse. Analysis of covariance adjusting for sex, age, body mass index, randomization and partial meniscectomy recorded at the 2-year follow-up was performed.
In patients who had developed medial tibiofemoral OA at the 5-year follow-up, the NSA and the HKA at the 2-year follow-up were smaller (NSA, mean difference = -4.6° [95% confidence interval {CI} -7.9° to -1.1°]; HKA, mean difference = -2.3° [95% CI -4.2° to -0.4°]). No association was observed between the NSA or HKA at the 2-year follow-up and lateral tibiofemoral OA, nor patellofemoral OA at the 5-year follow-up.
A smaller NSA and HKA angle of the ACL injured leg (i.e., more varus hip and varus knee alignment) 2 years after the injury was associated with medial tibiofemoral radiographic OA 3 years later.
Level II exploratory post hoc analysis of an RCT.
探讨前交叉韧带（ACL）损伤2年后评估的髋膝对线与3年后特定关节间室的膝关节影像学骨关节炎（OA）是否相关。
在膝关节ACL非手术与手术治疗（KANON）试验（ISRCTN84752559）中进行了探索性分析；115例急性ACL损伤患者在2年随访时接受评估；获取受伤腿的全下肢图像，并测量颈干角（NSA）和髋膝踝角（HKA）。在5年随访时，获得负重下的胫股关节和髌股关节X线片。根据国际骨关节炎研究学会图谱对X线片进行分级，影像学OA定义为接近Kellgren&Lawrence 2级或更严重。进行协方差分析，对性别、年龄、体重指数、随机分组以及2年随访时记录的部分半月板切除术进行校正。
在5年随访时发生内侧胫股关节OA的患者中，2年随访时的NSA和HKA较小（NSA，平均差异=-4.6°[95%置信区间{CI}-7.9°至-1.1°]；HKA，平均差异=-2.3°[95%CI-4.2°至-0.4°]）。2年随访时的NSA或HKA与外侧胫股关节OA之间未观察到关联，5年随访时也未观察到与髌股关节OA的关联。
ACL损伤腿在损伤2年后较小的NSA和HKA角（即髋内翻和膝内翻对线增加）与3年后内侧胫股关节影像学OA相关。
RCT的II级探索性事后分析。
