Epidemiology of intra- and peri-articular structural injuries in traumatic knee joint hemarthrosis – data from 1145 consecutive knees with subacute MRI

Olssón, Olle; Isacsson, Anders; Englund, Martin; Frobell, Richard

doi:10.1016/j.joca.2016.06.006

Cited by 59 publications

(73 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…30 Olsson et al reported that 88% of ACL injuries with traumatic hemarthrosis occur with concomitant structural injury with meniscus tears being the most common (55%). 31 In this study, an average of four other injured structures were seen with simultaneous ACL and PT ruptures. MRI should be used to evaluate patients presenting with traumatic hemarthrosis with suspicion for extensor mechanism, ligamentous, or meniscal injuries.…”

Section: Discussionmentioning

confidence: 70%

Surgical Management of Simultaneous Anterior Cruciate Ligament and Patellar Tendon Ruptures: A Systematic Review

et al. 2017

View full text Add to dashboard Cite

This study performs a systematic review to determine (1) if a significant difference exists in return to preinjury activity level between one- and two-stage treatment of combined anterior cruciate ligament (ACL) and patellar tendon (PT) tears; and (2) if a significant difference exists in the number of postoperative complications between the two differing surgical treatment approaches. A systematic review was performed using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and registered on PROSPERO. MEDLINE, Cochrane Central Register of Controlled Trials, SCOPUS, and Sport Discus were searched for English language level I-IV evidence studies on either one- (simultaneous) or two-stage (sequential) surgical treatment of simultaneously sustained ipsilateral ACL and PT tears. The approach to initial evaluation, diagnosis, treatment, and outcomes were qualitatively analyzed. Methodological quality assessment of all included studies was completed using the Methodological Index for Non-randomized Studies (MINORS). The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to assess quality of evidence and provide strength of recommendation. Statistical analyses were done using Fischer's exact test. Eleven articles (18 patients; 83% males; mean age, 31.1 ± 10.1 years; mean follow-up, 2.2 ± 1.7 years; and mean MINORS 7.8/16) were analyzed. Eight patients had a one-stage procedure (primary PT repair and ACL reconstruction), and 10 patients underwent a two-stage procedure (primary PT repair first followed by ACL reconstruction) with mean 28 ± 45.7 weeks (5 weeks-3 years) between surgeries. The rate for return to preinjury activity level after surgery was not significantly different between one- (88%) and two-stage (100%) ( = 0.444). There was a significantly higher complication rate ( = 0.023) in the one-stage (stiffness, instability, and patella baja) versus two-stage surgery (no complications). There was no significant difference in return to preinjury activity level between one- and two-stage PT repair and ACL reconstruction. However, the one-stage combined surgery had a significantly higher complication rate compared with two-stage surgery. The level of evidence is IV.

show abstract

Section: Discussionmentioning

confidence: 70%

Surgical Management of Simultaneous Anterior Cruciate Ligament and Patellar Tendon Ruptures: A Systematic Review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Men had higher absolute PASE scores than women, and the differences between men and women were most pronounced in the subscale related to sports activities, indicating that the type of activity might also have an impact on cartilage thickness loss. Nevertheless, a higher physical activity level may be related to a higher frequency of trauma and injury , and thus to a greater loss of cartilage, but we adjusted for knee injury in our analyses. Muscle weakness may have also influenced the sex‐specific relationship between physical activity and cartilage thickness.…”

Section: Discussionmentioning

confidence: 99%

Moderate Physical Activity and Prevention of Cartilage Loss in People With Knee Osteoarthritis: Data From the Osteoarthritis Initiative

Wirth

Juhl

Kemnitz

et al. 2019

Arthritis Care & Research

View full text Add to dashboard Cite

Objective. To examine the impact of physical activity on cartilage thickness loss in knee osteoarthritis (OA). Methods. A total of 689 participants with radiographic knee OA at baseline (Kellgren/Lawrence grade ≥2) from the Osteoarthritis Initiative completed the Physical Activity Scale for the Elderly (PASE) questionnaires at annual intervals over 4 years. Magnetic resonance imaging-based cartilage thickness change in the medial femorotibial compartment (MFTC) over 4 years was the main outcome. The impact of PASE tertiles (low, moderate, or high) on changes in MFTC cartilage thickness was estimated using a mixed-effects model adjusted for baseline characteristics. Furthermore, stratification by sex was performed for secondary analyses.Results. Structural progression of MFTC cartilage loss of −0.20 mm (95% confidence interval [95% CI] −0.22, −0.17) was observed in the entire cohort, with no significant difference between physical activity levels after adjustment for baseline characteristics. An interaction between sex and physical activity was observed in the adjusted analysis (P = 0.02). Stratification by sex showed that women with low physical activity had a statistically greater cartilage loss than women with moderate physical activity (adjusted between-group difference -0.09 mm [95% CI -0.16, 0.02]), whereas no significant differences were observed in men.Conclusion. While physical activity was not associated with cartilage thickness loss in the whole cohort, this relationship significantly differed between sexes. In women, but not in men, moderate physical activity may slow down structural disease progression compared to low physical activity levels. For both men and women, high physical activity levels do not appear to be more detrimental than lower physical activity levels for cartilage thickness loss.Clinicaltrials.gov identifier: NCT00080171.

show abstract

“…Whereas this was not expected, the upregulated analytes in the serum related to either clotting or inflammation with the exception of the insulin‐like growth factor‐binding proteins. Pathways including complement and coagulation and platelet activation are to be expected due to hemarthrosis into the knee joint after injury . ACL injury creates an influx of pro‐inflammatory markers, protein mediators and blood into the joint, which may perpetuate cartilage damage .…”

Section: Discussionmentioning

confidence: 99%

Upregulation of Systemic Inflammatory Pathways Following Anterior Cruciate Ligament Injury Relates to Both Cartilage and Muscular Changes: A Pilot Study

Hunt

Villasanta‐Tezanos

Butterfield

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

In conjunction with cartilage breakdown, muscle maladaptation including atrophy and increased fibrosis have been observed in the quadriceps following anterior cruciate ligament (ACL) injury. Previously observed upregulated muscle-related proteins in the synovial fluid following ACL rupture allude to cellular communication between the joint and muscle. Therefore, the purpose of this study was to determine whether muscle-related analytes are differentially expressed in the serum. Sixteen patients with an acute ACL tear participated in this IRB-approved study. Serum was obtained at two different time points at a mean of 6 and 14 days post-injury, and serum was analyzed by a highly multiplexed assay of 1,300 proteins. Pathway analysis using DAVID was performed; genes included met three criteria: significant change between the two study time points using a paired t test, significant change between the two study time points using a Mann-Whitney non-parametric test, and significant Benjamini post hoc analysis. Twelve analytes significantly increased between time points. Proteins chitinase-3-like protein 1 (p = 0.01), insulin-like growth factor binding protein 1 (p = 0.01), insulin-like growth factor binding protein 5 (p = 0.02), renin (p = 0.004), and lymphotoxin alpha 1: beta 2 (p = 0.03) were significantly upregulated in serum following acute ACL injury. The current results confirm the inflammatory pattern previously seen in the synovial fluid thought to play a role in the progression of post-traumatic osteoarthritis after ACL injury, and this data also provides further insights into important communication between the joint and quadriceps group, whose function is important in long term health.

show abstract

Epidemiology of intra- and peri-articular structural injuries in traumatic knee joint hemarthrosis – data from 1145 consecutive knees with subacute MRI

Cited by 59 publications

References 35 publications

Surgical Management of Simultaneous Anterior Cruciate Ligament and Patellar Tendon Ruptures: A Systematic Review

Surgical Management of Simultaneous Anterior Cruciate Ligament and Patellar Tendon Ruptures: A Systematic Review

Moderate Physical Activity and Prevention of Cartilage Loss in People With Knee Osteoarthritis: Data From the Osteoarthritis Initiative

Upregulation of Systemic Inflammatory Pathways Following Anterior Cruciate Ligament Injury Relates to Both Cartilage and Muscular Changes: A Pilot Study

Contact Info

Product

Resources

About