Anterior Cruciate Ligament OsteoArthritis Score (ACLOAS): Longitudinal MRI-based whole joint assessment of anterior cruciate ligament injury

Abstract

ACLOAS allows reliable scoring of acute ACL injury and longitudinal changes. This novel scoring system incorporates features that may be relevant for structural outcome not covered by established OA scoring instruments.

Early Knee Osteoarthritis Is Evident One Year Following Anterior Cruciate Ligament Reconstruction: A Magnetic Resonance Imaging Evaluation

“…Healing traumatic bone marrow lesions and newly developing OA‐associated bone marrow lesions may have different implications for future joint morphology. However, characteristics of the 2 bone marrow lesion types may overlap, posing a challenge for distinct delineation . Although the MOAKS does not distinguish between bone marrow lesion types , the majority of bone marrow lesions observed in the current study demonstrated degenerative characteristics (i.e., located directly subchondral, more circumscribed, and more commonly associated with cartilage damage) .…”

“…However, characteristics of the 2 bone marrow lesion types may overlap, posing a challenge for distinct delineation (14). Although the MOAKS does not distinguish between bone marrow lesion types (13), the majority of bone marrow lesions observed in the current study demonstrated degenerative characteristics (i.e., located directly subchondral, more circumscribed, and more commonly associated with cartilage damage) (14). The ACL OA Score semiquantitative instrument, recently designed specifically for ACL-injured knees, attempts to overcome this deficiency of the MOAKS.…”

“…The MOAKS has evolved from previous semiquantitative methods (11,12) by simplifying complex and cumbersome scoring criteria and omitting redundancies. While the recently published ACL OA Score has been designed specifically for ACL injuries, it was not published at the time of MRI analysis of the present study (14). The followup assessment in the ACL OA Score and MOAKS is similar, although we acknowledge that the ACL OA Score is better at taking into account osteochondral damage at baseline and subsequent structural sequelae.…”

Molecular and Structural Biomarkers of Inflammation at Two Years After Acute Anterior Cruciate Ligament Injury Do Not Predict Structural Knee Osteoarthritis at Five Years

“…Intraobserver reliability (kappa) for assessment of effusion‐synovitis for all time points scored was 0.85 (95% confidence interval [95% CI] 0.78, 0.92), and for Hoffa‐synovitis it was 0.54 (95% CI 0.42, 0.66). Interobserver reliability was 0.75 (95% CI 0.66, 0.84) and 0.60 (95% CI 0.48, 0.72), respectively .…”

“…All available MRIs were read by a musculoskeletal radiologist (FWR) according to the Anterior Cruciate Ligament OsteoArthritis Scoring (ACLOAS) system . ACLOAS was determined by analyzing nonenhanced MRI scans and using an assessment of inflammation that includes whole‐joint synovitis based on signal changes in Hoffa's fat pad (referred to as Hoffa‐synovitis) and a composite measure of the amount of intraarticular joint fluid and synovial thickening on fluid‐sensitive images (referred to as effusion‐synovitis).…”