Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2–3 years following anterior cruciate ligament reconstruction

David John Saxby, Adam L. Bryant, Ans van Ginckel, Yuanyuan Wang, Xinyang Wang, Luca Modenese, Pauline Gerus, Jason M. Konrath, Karine Fortin, Tim V. Wrigley, Kim L. Bennell, Flavia M. Cicuttini, Christopher Vertullo, Julian A. Feller, Tim Whitehead, Price Gallie, David G. Lloyd

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury. Methods: This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2–3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models. Results: In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ2(2) = 7.9, 95% confidence interval (CI) = 0.50–95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ2(2) = 4.2, 95% CI = 0.7–0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies. Conclusions: In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. Level of evidence: IV.

Original languageEnglish
Pages (from-to)707-715
Number of pages9
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume27
Issue number3
DOIs
Publication statusPublished - 14 Mar 2019

Keywords

  • Anterior cruciate ligament
  • Bone marrow lesions
  • Cartilage
  • Defects
  • Meniscus
  • Reconstruction

Cite this

Saxby, David John ; Bryant, Adam L. ; van Ginckel, Ans ; Wang, Yuanyuan ; Wang, Xinyang ; Modenese, Luca ; Gerus, Pauline ; Konrath, Jason M. ; Fortin, Karine ; Wrigley, Tim V. ; Bennell, Kim L. ; Cicuttini, Flavia M. ; Vertullo, Christopher ; Feller, Julian A. ; Whitehead, Tim ; Gallie, Price ; Lloyd, David G. / Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2–3 years following anterior cruciate ligament reconstruction. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2019 ; Vol. 27, No. 3. pp. 707-715.
@article{1c09a2cb66324a87a705ba84670cfe56,
title = "Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2–3 years following anterior cruciate ligament reconstruction",
abstract = "Purpose: External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury. Methods: This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2–3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models. Results: In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ2(2) = 7.9, 95{\%} confidence interval (CI) = 0.50–95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ2(2) = 4.2, 95{\%} CI = 0.7–0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies. Conclusions: In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. Level of evidence: IV.",
keywords = "Anterior cruciate ligament, Bone marrow lesions, Cartilage, Defects, Meniscus, Reconstruction",
author = "Saxby, {David John} and Bryant, {Adam L.} and {van Ginckel}, Ans and Yuanyuan Wang and Xinyang Wang and Luca Modenese and Pauline Gerus and Konrath, {Jason M.} and Karine Fortin and Wrigley, {Tim V.} and Bennell, {Kim L.} and Cicuttini, {Flavia M.} and Christopher Vertullo and Feller, {Julian A.} and Tim Whitehead and Price Gallie and Lloyd, {David G.}",
year = "2019",
month = "3",
day = "14",
doi = "10.1007/s00167-018-5006-3",
language = "English",
volume = "27",
pages = "707--715",
journal = "Knee Surgery, Sports Traumatology, Arthroscopy",
issn = "0942-2056",
publisher = "Springer-Verlag London Ltd.",
number = "3",

}

Saxby, DJ, Bryant, AL, van Ginckel, A, Wang, Y, Wang, X, Modenese, L, Gerus, P, Konrath, JM, Fortin, K, Wrigley, TV, Bennell, KL, Cicuttini, FM, Vertullo, C, Feller, JA, Whitehead, T, Gallie, P & Lloyd, DG 2019, 'Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2–3 years following anterior cruciate ligament reconstruction' Knee Surgery, Sports Traumatology, Arthroscopy, vol. 27, no. 3, pp. 707-715. https://doi.org/10.1007/s00167-018-5006-3

Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2–3 years following anterior cruciate ligament reconstruction. / Saxby, David John; Bryant, Adam L.; van Ginckel, Ans; Wang, Yuanyuan; Wang, Xinyang; Modenese, Luca; Gerus, Pauline; Konrath, Jason M.; Fortin, Karine; Wrigley, Tim V.; Bennell, Kim L.; Cicuttini, Flavia M.; Vertullo, Christopher; Feller, Julian A.; Whitehead, Tim; Gallie, Price; Lloyd, David G.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 27, No. 3, 14.03.2019, p. 707-715.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Greater magnitude tibiofemoral contact forces are associated with reduced prevalence of osteochondral pathologies 2–3 years following anterior cruciate ligament reconstruction

AU - Saxby, David John

AU - Bryant, Adam L.

AU - van Ginckel, Ans

AU - Wang, Yuanyuan

AU - Wang, Xinyang

AU - Modenese, Luca

AU - Gerus, Pauline

AU - Konrath, Jason M.

AU - Fortin, Karine

AU - Wrigley, Tim V.

AU - Bennell, Kim L.

AU - Cicuttini, Flavia M.

AU - Vertullo, Christopher

AU - Feller, Julian A.

AU - Whitehead, Tim

AU - Gallie, Price

AU - Lloyd, David G.

PY - 2019/3/14

Y1 - 2019/3/14

N2 - Purpose: External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury. Methods: This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2–3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models. Results: In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ2(2) = 7.9, 95% confidence interval (CI) = 0.50–95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ2(2) = 4.2, 95% CI = 0.7–0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies. Conclusions: In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. Level of evidence: IV.

AB - Purpose: External loading of osteoarthritic and healthy knees correlates with current and future osteochondral tissue state. These relationships have not been examined following anterior cruciate ligament reconstruction. We hypothesised greater magnitude tibiofemoral contact forces were related to increased prevalence of osteochondral pathologies, and these relationships were exacerbated by concomitant meniscal injury. Methods: This was a cross-sectional study of 100 individuals (29.7 ± 6.5 years, 78.1 ± 14.4 kg) examined 2–3 years following hamstring tendon anterior cruciate ligament reconstruction. Thirty-eight participants had concurrent meniscal pathology (30.6 ± 6.6 years, 83.3 ± 14.3 kg), which included treated and untreated meniscal injury, and 62 participants (29.8 ± 6.4 years, 74.9 ± 13.3 kg) were free of meniscal pathology. Magnetic resonance imaging of reconstructed knees was used to assess prevalence of tibiofemoral osteochondral pathologies (i.e., cartilage defects and bone marrow lesions). A calibrated electromyogram-driven neuromusculoskeletal model was used to predict medial and lateral tibiofemoral compartment contact forces from gait analysis data. Relationships between contact forces and osteochondral pathology prevalence were assessed using logistic regression models. Results: In patients with reconstructed knees free from meniscal pathology, greater medial contact forces were related to reduced prevalence of medial cartilage defects (odds ratio (OR) = 0.7, Wald χ2(2) = 7.9, 95% confidence interval (CI) = 0.50–95, p = 0.02) and medial bone marrow lesions (OR = 0.8, Wald χ2(2) = 4.2, 95% CI = 0.7–0.99, p = 0.04). No significant relationships were found in lateral compartments. In reconstructed knees with concurrent meniscal pathology, no relationships were found between contact forces and osteochondral pathologies. Conclusions: In patients with reconstructed knees free from meniscal pathology, increased contact forces were associated with fewer cartilage defects and bone marrow lesions in medial, but not, lateral tibiofemoral compartments. No significant relationships were found between contact forces and osteochondral pathologies in reconstructed knees with meniscal pathology for any tibiofemoral compartment. Future studies should focus on determining longitudinal effects of contact forces and changes in osteochondral pathologies. Level of evidence: IV.

KW - Anterior cruciate ligament

KW - Bone marrow lesions

KW - Cartilage

KW - Defects

KW - Meniscus

KW - Reconstruction

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U2 - 10.1007/s00167-018-5006-3

DO - 10.1007/s00167-018-5006-3

M3 - Article

VL - 27

SP - 707

EP - 715

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

IS - 3

ER -