Hassanlou L, Bowes M A, Turkiewicz A, Kvist J, Gauffin H, Frobell R, Saarakkala S, Englund M
Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Finland.
Imorphics Ltd, Manchester, UK.
Osteoarthr Cartil Open. 2025 Jul 17;7(3):100652. doi: 10.1016/j.ocarto.2025.100652. eCollection 2025 Sep.
To determine bone shape changes over two years after acute anterior cruciate ligament (ACL) injury and to compare knees treated with ACL reconstruction (ACLR) vs no ACLR.
We used prospective data involving 129 young adults (46 % female, mean age 25 years) with recent ACL injury from a subcohort within the prospective multicenter NACOX study. Patients were treated according to Swedish guidelines with supervised rehabilitation before considering ACLR. 3D MR images obtained at baseline, 3-, 6-, 12, and 24-months post-injury were assessed for changes in the femur and tibia bone surface area using active appearance models. We used a linear mixed-effects model adjusted for age, sex, body mass index, and pre-injury Tegner physical activity level.
We observed growth in bone areas over the first two years, particularly in the medial femur and medial tibia, with an average relative increase of 1.28 % (95 % CI 0.67 %, 1.88 %) and 1.04 % (0.44 %, 1.65 %), respectively. The lateral femur also showed growth, with an increase of 1.15 % (0.55 %, 1.75 %). We found little differences comparing ACLR patients to non-ACLR patients, adjusted relative percentage differences: medial femur, 0.01 % (95 % CI: 0.9 %, 1.1 %); medial tibia, -0.03 % (-1.2 %, 0.7 %); lateral femur, 0.04 % (-0.6 %, 1.4 %); and lateral tibia, -0.11 % (-2.1 %, -0.1 %).
After acute ACL injury, there is a growth primarily in the medial femoral and tibial condyles. The bone shape changes could hypothetically be a response to altered biomechanical conditions and may precede the development of knee OA.
确定急性前交叉韧带（ACL）损伤后两年内的骨形态变化，并比较接受ACL重建（ACLR）与未接受ACLR治疗的膝关节情况。
我们使用了前瞻性数据，这些数据来自前瞻性多中心NACOX研究中的一个亚组，涉及129名近期ACL损伤的年轻成年人（46%为女性，平均年龄25岁）。在考虑ACLR之前，患者按照瑞典指南接受有监督的康复治疗。使用主动外观模型评估在基线、损伤后3个月、6个月、12个月和24个月获得的3D MR图像中股骨和胫骨骨表面积的变化。我们使用了一个线性混合效应模型，并对年龄、性别、体重指数和损伤前的Tegner身体活动水平进行了调整。
我们观察到在最初两年中骨面积有所增加，特别是在内侧股骨和内侧胫骨，平均相对增加分别为1.28%（95%CI 0.67%，1.88%）和1.04%（0.44%，1.65%）。外侧股骨也显示出增长，增加了1.15%（0.55%，1.75%）。我们发现ACLR患者与未接受ACLR治疗的患者之间差异不大，调整后的相对百分比差异为：内侧股骨，0.01%（95%CI：0.9%，1.1%）；内侧胫骨，-0.03%（-1.2%，0.7%）；外侧股骨，0.04%（-0.6%，1.4%）；外侧胫骨，-0.11%（-2.1%，-0.1%）。
急性ACL损伤后，主要在内侧股骨髁和胫骨髁出现生长。骨形态变化可能是对生物力学条件改变的一种反应，并且可能在膝关节骨关节炎发展之前出现。
