Biomechancial Threshold Values For Identifying Posttraumatic Osteoarthritis-Related Symptoms Six Months Following Anterior Cruciate Ligament Reconstruction

Buck, A.N.; Lisee, C.M.; Bjornsen, E.S.; T.A., Schwartz,; Spang, J.T.; Franz, J.R.; Blackburn, J.T.; Pietrosimone, B.G.

doi:10.1016/j.joca.2023.01.075

Cited by 1 publication

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“…In this work, we have applied dualMRI and qMRI techniques in a clinical cohort of patients six months post-ACLR to determine which MRI metrics may best predict patient-reported outcomes. While previous work has quantified macro-scale whole joint mechanical changes post ACLR 3,18,21,50 , to our knowledge, this is the first study that has quantified cartilage tissue-level (i.e., intratissue) mechanical changes in this clinical population. This study had two objectives: first, we evaluated the extent that dualMRI and qMRI metrics are associated with knee function and pain at six-months post-ACLR, as assessed by standardized patient-reported outcome scores 16,41 .…”

Section: Introductionmentioning

confidence: 99%

MRI-derived Articular Cartilage Strains Predict Patient-Reported Outcomes Six Months Post Anterior Cruciate Ligament Reconstruction

Miller,

Lee,

Lowe

et al. 2024

Preprint

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Background: Anterior cruciate ligament (ACL) injuries lead to an increased risk of osteoarthritis, characterized by altered cartilage tissue structure and function. Displacements under applied loading by magnetic resonance imaging (dualMRI) is a novel MRI technique that can be used to quantify mechanical strain in cartilage while undergoing a physiological load. Purpose: To determine if strains derived by dualMRI and relaxometry measures correlate with patient-reported outcomes at six months post unilateral ACL reconstruction. Study Design: Cohort study Methods: Quantitative MRI (T2, T2*, T1ρ) measurements and transverse, axial, and shear strains were quantified in the medial articular tibiofemoral cartilage of 35 participants at six-months post unilateral ACL reconstruction. The relationships between patient-reported outcomes (WOMAC, KOOS, MARS) and all qMRI relaxation times were quantified using general linear mixed-effects models. A combined best-fit multicontrast MRI model was then developed using backwards regression to determine the patient features and MRI metrics that are most predictive of patient-reported outcome scores. Results: Higher femoral strains were significantly correlated with worse patient-reported functional outcomes. Femoral shear and transverse strains were positively correlated with six-month KOOS and WOMAC scores, after controlling for covariates. No relaxometry measures were correlated with patient-reported outcome scores. We identified the best-fit model for predicting WOMAC score using multiple MRI measures and patient-specific information, including sex, age, graft type, femoral transverse strain, femoral axial strain, and femoral shear strain. The best-fit model significantly predicted WOMAC score (p<0.001) better than any one individual MRI metric alone. When we regressed the model-predicted WOMAC scores against the patient-reported WOMAC scores, we found that our model achieved a goodness of fit exceeding 0.52. Conclusions: This work presents the first use of dualMRI in vivo in a cohort of participants at risk for developing osteoarthritis. Our results indicate that both shear and transverse strains are highly correlated with patient-reported outcome severity could serve as novel imaging biomarkers to predict the development of osteoarthritis.

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