Changes to the articular cartilage thickness profile of the tibia following anterior cruciate ligament injury

Argentieri, Erin C.; Sturnick, Daniel R.; DeSarno, Michael; Gardner‐Morse, Mack; Slauterbeck, James R.; Johnson, Robert J.; Beynnon, Bruce D.

doi:10.1016/j.joca.2014.06.025

Cited by 22 publications

(58 citation statements)

References 48 publications

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“…A critical step in addressing this knowledge gap is to determine how combined ACL and meniscus injury affects knee structure and geometry soon after injury. Our previous studies reveal that the index trauma has an immediate effect on the geometric profiles of articular structures and articular cartilage thickness . However, this work and that of others did not study ACL disruption with concomitant meniscal injury and isolated ACL disruption without meniscal injury .…”

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confidence: 72%

“…Characterization of the position of the tibia relative to the femur during MRI acquisition was accomplished by establishing three‐dimensional, bone‐based coordinate systems within the femur and tibia (Fig. ) . The following three‐dimensional (3D) measurements of the geometry of the tibial articular cartilage surface, underlying tibial subchondral bone, and meniscus were made relative to the 3D bone‐based coordinate systems using the approaches that have been described (Table ) .…”

Section: Methodsmentioning

confidence: 99%

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Combined Injury to the ACL and Lateral Meniscus Alters the Geometry of Articular Cartilage and Meniscus Soon After Initial Trauma

Beynnon

Fiorentino

Gardner‐Morse

et al. 2019

Journal Orthopaedic Research

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Combined injury to the anterior cruciate ligament (ACL) and meniscus is associated with earlier onset and increased rates of post‐traumatic osteoarthritis compared with isolated ACL injury. However, little is known about the initial changes in joint structure associated with these different types of trauma. We hypothesized that trauma to the ACL and lateral meniscus has an immediate effect on morphometry of the articular cartilage and meniscus about the entire tibial plateau that is more pronounced than an ACL tear without meniscus injury. Subjects underwent magnetic resonance imaging scanning soon after injury and prior to surgery. Those that suffered injury to the ACL and lateral meniscus underwent changes in the lateral compartment (increases in the posterior–inferior directed slopes of the articular cartilage surface, and the wedge angle of the posterior horn of the meniscus) and medial compartment (the cartilage‐to‐bone height decreased in the region located under the posterior horn of the meniscus, and the thickness of cartilage increased and decreased in the mid and posterior regions of the plateau, respectively). Subjects that suffered an isolated ACL tear did not undergo the same magnitude of change to these articular structures. A majority of the changes in morphometry occurred in the lateral compartment of the knee; however, change in the medial compartment of the knee with a normal appearing meniscus also occurred. Statement of clinical significance: Knee injuries that involve combined trauma to the ACL and meniscus directly affect both compartments of the knee, even if the meniscus and articular cartilage appears normal upon arthroscopic examination. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:759‐767, 2020

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confidence: 72%

Section: Methodsmentioning

confidence: 99%

Combined Injury to the ACL and Lateral Meniscus Alters the Geometry of Articular Cartilage and Meniscus Soon After Initial Trauma

Beynnon

Fiorentino

Gardner‐Morse

et al. 2019

Journal Orthopaedic Research

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“…This approach does not take into consideration that the ACL injury itself is capable of producing both shortterm and long-term changes in knee-joint geometry. 1,5 Furthermore, few investigators have used measurement techniques with established interobserver and intraobserver measurement reliability.10 Finally, many researchers have evaluated men and women as a combined group. However, in light of the disparities that exist between the sexes in ACL injury rates, knee-joint geometry, anatomical alignment, joint laxity, demographic characteristics, and strength, male and female models of injury risk should be considered separately.…”

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confidence: 99%

“…[1][2][3][4][5][6][7][8] Regardless of whether a patient chooses surgical or nonsurgical treatment, ACL injury is associated with the onset of posttraumatic arthritis. 9 Consequently, recent researchers have focused on understanding the mechanisms and factors that place individuals at increased risk for sustaining this severe injury.…”

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confidence: 99%

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confidence: 99%

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A Sex-Stratified Multivariate Risk Factor Model for Anterior Cruciate Ligament Injury

Beynnon¹,

Sturnick

Argentieri³

et al. 2015

Journal of Athletic Training

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A nterior cruciate ligament (ACL) injuries produce significant joint trauma and have been implicated as the inciting event for both short-term and longterm changes within the articular structures of the knee. [1][2][3][4][5][6][7][8] Regardless of whether a patient chooses surgical or nonsurgical treatment, ACL injury is associated with the onset of posttraumatic arthritis. 9 Consequently, recent researchers have focused on understanding the mechanisms and factors that place individuals at increased risk for sustaining this severe injury. However, variations in study designs and methods have led to conflicting reports regarding these relationships. For example, exclusion criteria used for control participants (eg, combining control participants who have a history of knee pain with those who have normal, pain-free knees) and the approaches used to match case and control participants vary widely among studies. In addition, previous authors have obtained data from the affected knees of ACL-injured patients after the injury. This approach does not take into consideration that the ACL injury itself is capable of producing both shortterm and long-term changes in knee-joint geometry. 1,5 Furthermore, few investigators have used measurement techniques with established interobserver and intraobserver measurement reliability.10 Finally, many researchers have evaluated men and women as a combined group. However, in light of the disparities that exist between the sexes in ACL injury rates, knee-joint geometry, anatomical alignment, joint laxity, demographic characteristics, and strength, male and female models of injury risk should be considered separately. 11This keynote presentation provided a summary of findings from our group's previous and ongoing research efforts that have focused on identifying the factors associated with increased risk of ACL injury. For clarity, the findings are organized in 3 sections: ''Epidemiology of ACL Injury,'' ''Evaluation of ACL Injury Screening Tools,'' and ''Development of ACL Injury Risk Models.'' Epidemiology of ACL InjuryOur epidemiology investigation evaluated the independent effects of athlete sex, level of competition, and sport on the risk of sustaining an ACL injury. 11 We prospectively followed athletes from 26 institutions (8 colleges, 18 high schools) over 4 years to determine the incidence of firsttime, noncontact ACL injuries. After controlling for differences in level of play and sport, we found that an athlete's sex had an independent influence on the risk of injury: female athletes' risk of experiencing a noncontact ACL injury was 2.10 times greater than that of their male counterparts.11 When athlete sex and sport were controlled, collegiate athletes were at greater risk for incurring a noncontact ACL injury than were high school athletes (relative risk [RR] ¼ 2.38). 11When controlling for athlete sex and level of play, we observed that the risk of sustaining a noncontact ACL injury was greatest in soccer (RR ¼ 1.77) and rugby (RR ¼ 2.23) compared with all other sports s...

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Relationship between synovial fluid biomarkers of articular cartilage metabolism and the patient's perspective of outcome depends on the severity of articular cartilage damage following ACL trauma

et al. 2015

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Anterior cruciate ligament (ACL) trauma often occurs in combination with injury to the articular cartilage of the knee, this can result in earlier radiographic evidence of post traumatic osteoarthritis (OA) of the knee compared to the contralateral, ACL intact knee; however, the biomechanical and biological mechanisms associated with the onset and progression of this disease are not understood. We sought to gain insight into the mechanisms by determining the relationship between articular cartilage injury associated with ACL trauma and the expression of synovial fluid biomarkers of articular cartilage metabolism, and to evaluate the relationship between these biomarkers and the patient's perspective of the outcomes. Synovial fluid samples were acquired from 39 ACL injured subjects at an average of 10 weeks after injury, and 32 control subjects with normal knees (documented with clinical exam and MRI assessment). Subjects in the ACL-injured group were classified as low-risk for future OA if they displayed an International Cartilage Repair Society (ICRS) Grade 2 articular cartilage lesion or less and high-risk for future OA if they had an ICRS Grade 3A articular cartilage lesion. The patient's perspective of the injury was evaluated with the Knee Injury and Osteoarthritis Outcomes Score (KOOS). There were no significant differences in mean concentrations of the markers of type II collagen metabolism (CPII, C2C, and C1,2C) or the aggrecan breakdown Alanine-Arginine-Glycine-Serine (ARGS) -fragment between control subjects and the subjects in the low-and high-risk groups (p-value range: 0.80-0.43). Associations between ARGS-aggrecan concentration and KOOS subscales of symptoms and pain were significantly different between the low-and high-risk groups (p ¼ 0.03 and p ¼ 0.01, respectively). Likewise, there was strong evidence in support of an association between the markers of type II collagen metabolism (C1,2C and CPII concentrations) and the KOOS subscale of pain between the low-and high-risk groups (p ¼ 0.051 and 0.077, correspondingly). In ACL injured subjects with concomitant Grade 3A articular cartilage injuries, concentrations of synovial fluid ARGS-aggrecan were directly associated with improvements in KOOS symptoms and pain. These findings suggest the possible involvement of ARGS-aggrecan in a localized tissue repair response involving an increase in aggrecan turnover following severe knee trauma. ß

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Changes to the articular cartilage thickness profile of the tibia following anterior cruciate ligament injury

Abstract: ACL-injured females displayed cartilage thickness differences in the central, and posterior medial tibial cartilage regions. Tibial position effected thickness differences, but did not account for all significant differences.

Cited by 22 publications

References 48 publications

Combined Injury to the ACL and Lateral Meniscus Alters the Geometry of Articular Cartilage and Meniscus Soon After Initial Trauma

Combined Injury to the ACL and Lateral Meniscus Alters the Geometry of Articular Cartilage and Meniscus Soon After Initial Trauma

A Sex-Stratified Multivariate Risk Factor Model for Anterior Cruciate Ligament Injury

Relationship between synovial fluid biomarkers of articular cartilage metabolism and the patient's perspective of outcome depends on the severity of articular cartilage damage following ACL trauma

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