Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Bone shape changes over two years following acute anterior cruciate ligament injury: Reconstructed vs non-reconstructed knees

Hassanlou, Leila LU orcid ; Bowes, M. A. ; Turkiewicz, A. LU ; Kvist, J. ; Gauffin, H. ; Frobell, R. LU ; Saarakkala, S. LU and Englund, M. LU orcid (2025) In Osteoarthritis and Cartilage Open 7(3).
Abstract

Objective: 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. Design: 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... (More)

Objective: 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. Design: 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. Results: 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 ​%). Conclusion: 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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ACL, Bone, Early-stage OA, Knee, Magnetic resonance imaging
in
Osteoarthritis and Cartilage Open
volume
7
issue
3
article number
100652
publisher
Elsevier
external identifiers
  • scopus:105011055550
  • pmid:40735539
ISSN
2665-9131
DOI
10.1016/j.ocarto.2025.100652
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025
id
54b48da0-4c85-482f-bec9-8527cbd0d743
date added to LUP
2025-11-13 09:53:14
date last changed
2025-11-14 03:42:17
@article{54b48da0-4c85-482f-bec9-8527cbd0d743,
  abstract     = {{<p>Objective: 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. Design: 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. Results: 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 ​%). Conclusion: 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.</p>}},
  author       = {{Hassanlou, Leila and Bowes, M. A. and Turkiewicz, A. and Kvist, J. and Gauffin, H. and Frobell, R. and Saarakkala, S. and Englund, M.}},
  issn         = {{2665-9131}},
  keywords     = {{ACL; Bone; Early-stage OA; Knee; Magnetic resonance imaging}},
  language     = {{eng}},
  number       = {{3}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage Open}},
  title        = {{Bone shape changes over two years following acute anterior cruciate ligament injury: Reconstructed vs non-reconstructed knees}},
  url          = {{http://dx.doi.org/10.1016/j.ocarto.2025.100652}},
  doi          = {{10.1016/j.ocarto.2025.100652}},
  volume       = {{7}},
  year         = {{2025}},
}