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Marked and rapid change of bone shape in acutely ACL injured knees – an exploratory analysis of the Kanon trial

Bowes, M. A.; Lohmander, L. S. LU ; Wolstenholme, C. B.H.; Vincent, G. R.; Conaghan, P. G. and Frobell, R. B. LU (2019) In Osteoarthritis and Cartilage 27(4). p.638-645
Abstract

Background: To investigate changes in knee 3D bone shape over the first 5 years after acute anterior cruciate ligament (ACL) injury in participants of the randomized controlled KANON-trial. Methods: Serial MR images over 5 years from 121 young (32 women, mean age 26.1 years) adults with an acute ACL tear in a previously un-injured knee were analyzed using statistical shape models for bone. A matched reference cohort of 176 individuals was selected from the Osteoarthritis Initiative (OAI). Primary endpoint was change in bone area of the medial femoral condyle; exploratory analyses compared results by treatment and examined other knee regions. Comparisons were made using repeated measures mixed model ANOVA with adjustment for age, sex and... (More)

Background: To investigate changes in knee 3D bone shape over the first 5 years after acute anterior cruciate ligament (ACL) injury in participants of the randomized controlled KANON-trial. Methods: Serial MR images over 5 years from 121 young (32 women, mean age 26.1 years) adults with an acute ACL tear in a previously un-injured knee were analyzed using statistical shape models for bone. A matched reference cohort of 176 individuals was selected from the Osteoarthritis Initiative (OAI). Primary endpoint was change in bone area of the medial femoral condyle; exploratory analyses compared results by treatment and examined other knee regions. Comparisons were made using repeated measures mixed model ANOVA with adjustment for age, sex and body mass index (BMI). Results: Mean medial femur bone area increased 3.2% (78.0 [95% CI 70.2 to 86.4] mm2) over 5 years after ACL injury and most prominently in knees treated with ACL reconstruction (ACLR). A higher rate of increase occurred over the first 2 years compared to the latter 3-years (66.2 [59.3 to 73.2] vs 17.6 [12.2 to 23.0] mm2) and was 6.7 times faster than in the reference cohort. The pattern and location of shape change in the extrapolated KANON data was very similar to that observed in another knee-osteoarthritis cohort. Conclusion: 3D shape modelling after acute ACL injury revealed rapid bone shape changes, already evident at 3 months. The bone-change pattern after ACL injury demonstrated flattening and bone growth on the outer margins of the condyles similar to that reported in established knee osteoarthritis.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ACL tear, Bone shape, Osteoarthritis
in
Osteoarthritis and Cartilage
volume
27
issue
4
pages
638 - 645
publisher
Elsevier
external identifiers
  • scopus:85061089156
ISSN
1063-4584
DOI
10.1016/j.joca.2018.12.021
language
English
LU publication?
yes
id
095f0158-3311-44ba-9ad1-f86a62027250
date added to LUP
2019-02-12 13:41:06
date last changed
2019-08-14 04:32:26
@article{095f0158-3311-44ba-9ad1-f86a62027250,
  abstract     = {<p>Background: To investigate changes in knee 3D bone shape over the first 5 years after acute anterior cruciate ligament (ACL) injury in participants of the randomized controlled KANON-trial. Methods: Serial MR images over 5 years from 121 young (32 women, mean age 26.1 years) adults with an acute ACL tear in a previously un-injured knee were analyzed using statistical shape models for bone. A matched reference cohort of 176 individuals was selected from the Osteoarthritis Initiative (OAI). Primary endpoint was change in bone area of the medial femoral condyle; exploratory analyses compared results by treatment and examined other knee regions. Comparisons were made using repeated measures mixed model ANOVA with adjustment for age, sex and body mass index (BMI). Results: Mean medial femur bone area increased 3.2% (78.0 [95% CI 70.2 to 86.4] mm<sup>2</sup>) over 5 years after ACL injury and most prominently in knees treated with ACL reconstruction (ACLR). A higher rate of increase occurred over the first 2 years compared to the latter 3-years (66.2 [59.3 to 73.2] vs 17.6 [12.2 to 23.0] mm<sup>2</sup>) and was 6.7 times faster than in the reference cohort. The pattern and location of shape change in the extrapolated KANON data was very similar to that observed in another knee-osteoarthritis cohort. Conclusion: 3D shape modelling after acute ACL injury revealed rapid bone shape changes, already evident at 3 months. The bone-change pattern after ACL injury demonstrated flattening and bone growth on the outer margins of the condyles similar to that reported in established knee osteoarthritis.</p>},
  author       = {Bowes, M. A. and Lohmander, L. S. and Wolstenholme, C. B.H. and Vincent, G. R. and Conaghan, P. G. and Frobell, R. B.},
  issn         = {1063-4584},
  keyword      = {ACL tear,Bone shape,Osteoarthritis},
  language     = {eng},
  month        = {01},
  number       = {4},
  pages        = {638--645},
  publisher    = {Elsevier},
  series       = {Osteoarthritis and Cartilage},
  title        = {Marked and rapid change of bone shape in acutely ACL injured knees – an exploratory analysis of the Kanon trial},
  url          = {http://dx.doi.org/10.1016/j.joca.2018.12.021},
  volume       = {27},
  year         = {2019},
}