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Five-Year Followup of Knee Joint Cartilage Thickness Changes After Acute Rupture of the Anterior Cruciate Ligament

Eckstein, F. ; Wirth, W. ; Lohmander, Stefan LU orcid ; Hudelmaier, M. I. and Frobell, Richard LU (2015) In Arthritis & Rheumatology 67(1). p.152-161
Abstract
Objective. Anterior cruciate ligament (ACL) rupture involves an increased risk of osteoarthritis. The purpose of this study was to explore changes in cartilage thickness over 5 years after ACL rupture. Methods. A total of 121 young active adults (ages 18-35 years; 26% women) from the Knee ACL, Nonsurgical versus Surgical Treatment (KANON) study, who had acute traumatic rupture of the ACL were studied. Sagittal magnetic resonance images were acquired within 4 weeks of ACL rupture (baseline) and at the 2-year and 5-year followup assessments. Medial and lateral femorotibial cartilage was segmented (with blinding to acquisition order), and the mean cartilage thickness was computed across 16 femorotibial subregions. Total femorotibial cartilage... (More)
Objective. Anterior cruciate ligament (ACL) rupture involves an increased risk of osteoarthritis. The purpose of this study was to explore changes in cartilage thickness over 5 years after ACL rupture. Methods. A total of 121 young active adults (ages 18-35 years; 26% women) from the Knee ACL, Nonsurgical versus Surgical Treatment (KANON) study, who had acute traumatic rupture of the ACL were studied. Sagittal magnetic resonance images were acquired within 4 weeks of ACL rupture (baseline) and at the 2-year and 5-year followup assessments. Medial and lateral femorotibial cartilage was segmented (with blinding to acquisition order), and the mean cartilage thickness was computed across 16 femorotibial subregions. Total femorotibial cartilage thickness change was the primary analytic focus. Maximal subregional mean cartilage thickness loss (ordered value 1 [OV1]) and gain (ordered value 16 [OV16]), independent of its specific location in individual knees, were the secondary analytic focus. Results. Overall femorotibial cartilage thickness increased by 31 mu m/year over 5 years (95% confidence interval 18, 44). The increase was similar in men and women and was significantly greater in those younger, as compared with those older, than the median age (25.3 years). The rate of total cartilage thickness change did not differ significantly between the first 2 years and the later 3 years. However, the maximal annualized subregional cartilage loss (OV1) and gain (OV16) were both significantly greater (P < 0.001 and P < 0.05, respectively) during the earlier interval than during the later interval (-115 versus -54 mu m [OV1] and 116 versus 69 mu m [OV16]). Conclusion. Cartilage thickening was observed over 5 years following ACL injury, particularly in the medial femorotibial compartment and in younger subjects. Major perturbations in cartilage homeostasis were seen over the first 2 years after ACL rupture, with simultaneous subregional thinning and thickening occurring within the same cartilage plate or compartment. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis & Rheumatology
volume
67
issue
1
pages
152 - 161
publisher
John Wiley & Sons Inc.
external identifiers
  • wos:000346917700016
  • scopus:84919914892
  • pmid:25252019
ISSN
2326-5191
DOI
10.1002/art.38881
language
English
LU publication?
yes
id
01755587-e5a7-4eb8-9ea1-fe2ae1acfb25 (old id 5085101)
date added to LUP
2016-04-01 14:09:58
date last changed
2023-01-11 22:42:48
@article{01755587-e5a7-4eb8-9ea1-fe2ae1acfb25,
  abstract     = {{Objective. Anterior cruciate ligament (ACL) rupture involves an increased risk of osteoarthritis. The purpose of this study was to explore changes in cartilage thickness over 5 years after ACL rupture. Methods. A total of 121 young active adults (ages 18-35 years; 26% women) from the Knee ACL, Nonsurgical versus Surgical Treatment (KANON) study, who had acute traumatic rupture of the ACL were studied. Sagittal magnetic resonance images were acquired within 4 weeks of ACL rupture (baseline) and at the 2-year and 5-year followup assessments. Medial and lateral femorotibial cartilage was segmented (with blinding to acquisition order), and the mean cartilage thickness was computed across 16 femorotibial subregions. Total femorotibial cartilage thickness change was the primary analytic focus. Maximal subregional mean cartilage thickness loss (ordered value 1 [OV1]) and gain (ordered value 16 [OV16]), independent of its specific location in individual knees, were the secondary analytic focus. Results. Overall femorotibial cartilage thickness increased by 31 mu m/year over 5 years (95% confidence interval 18, 44). The increase was similar in men and women and was significantly greater in those younger, as compared with those older, than the median age (25.3 years). The rate of total cartilage thickness change did not differ significantly between the first 2 years and the later 3 years. However, the maximal annualized subregional cartilage loss (OV1) and gain (OV16) were both significantly greater (P &lt; 0.001 and P &lt; 0.05, respectively) during the earlier interval than during the later interval (-115 versus -54 mu m [OV1] and 116 versus 69 mu m [OV16]). Conclusion. Cartilage thickening was observed over 5 years following ACL injury, particularly in the medial femorotibial compartment and in younger subjects. Major perturbations in cartilage homeostasis were seen over the first 2 years after ACL rupture, with simultaneous subregional thinning and thickening occurring within the same cartilage plate or compartment.}},
  author       = {{Eckstein, F. and Wirth, W. and Lohmander, Stefan and Hudelmaier, M. I. and Frobell, Richard}},
  issn         = {{2326-5191}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{152--161}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis & Rheumatology}},
  title        = {{Five-Year Followup of Knee Joint Cartilage Thickness Changes After Acute Rupture of the Anterior Cruciate Ligament}},
  url          = {{http://dx.doi.org/10.1002/art.38881}},
  doi          = {{10.1002/art.38881}},
  volume       = {{67}},
  year         = {{2015}},
}