Joint effusion at 6 months is a significant predictor of joint effusion 1 year after anterior cruciate ligament reconstruction

Abstract

Purpose This study aimed to assess the risk factors for prolonged joint efusion in patients undergoing double-bundle anterior cruciate ligament reconstruction (ACLR). Methods In total, 160 patients who underwent primary ACLR using autograft hamstring between 2015 and 2018 were retrospectively reviewed. Joint efusion was deined as any grade ≥ 2 (range, 0-3) according to the MRI Osteoarthritis Knee Score (MOAKS). Univariate and multivariate logistic regression analyses were performed. ResultsThe median age of the patients was 25 years (range 14-68 years) at the time of the surgery; there were 89 women and 71 men. At 1 year, 46 (28.8%) patients experienced knee joint efusion, as deined by the MOAKS. Univariate analysis revealed that age, preoperative Kellgren-Lawrence (K-L) grade, and joint efusion at 6 months were signiicantly associated with joint efusion at 1 year. In the multivariate analysis, joint efusion at 6 months was signiicantly associated with joint efusion at 1 year (odds ratio, 68.0; 95% conidence interval, 22.1-209.4). No signiicant diference in the Lysholm scores was observed between patients with and without joint efusion at 1 year (n.s.). Conclusions Joint efusion at 6 months was signiicantly associated with joint efusion 1 year after ACLR. Level of evidence III.

Joint effusion at 3 months after anterior cruciate ligament reconstruction is associated with reinjury

“…A previous study reported an increased volume of knee synovial fluid at 3 and 6 months postoperatively compared to that in patients treated conservatively; however, at 1 year postoperatively, the volumes were equivalent [9]. Ogura et al reported that when comparing patients with and without joint effusion at 1 year after ACLR, those with more joint effusion were significantly older, had evidence of more advanced osteoarthritis on preoperative radiographs, and had higher volumes of joint effusion at 6 months after surgery [20]. Furthermore, they reported that there were no significant differences in the Lysholm score according to the presence or absence of joint fluid at 1 year postoperatively.…”

Ultrasound-detected effusion-synovitis is associated with greater limb loading rate asymmetry during walking post-ACL reconstruction: A pilot study

“…ACL rupture initiates a sequence of events involving persistent inflammation and altered walking biomechanics [ 6 , 7 ], which significantly contributes to the onset and progression of post-traumatic OA [ 8 , 9 ] Extensive evidence indicates ACL injury triggers an initial inflammatory response associated with poor patient-reported outcomes at 2-year follow-up [ 10 , 11 ] Subsequent ACLR then reinitiates this inflammatory response leading to elevated inflammatory biomarkers (i.e., IL-1β, IL-6, IFNγ) persisting ≥5 year post-operatively [ 12 , 13 ] Moreover, the presence of effusion-synovitis, an imaging marker of inflammation, is frequently detected on magnetic resonance imaging (MRI) at 3 and 6 months post-ACLR, and this finding relates to degenerative joint changes by 2 years after surgery [ 14 , 15 ] Concurrently, altered walking biomechanics, including vertical ground reaction force peak magnitude (vGRF)and loading rate (vGRF-LR), are pervasive post-ACLR and by modifying knee joint loads are considered instrumental in development of OA [ 6 , 16 ] Beyond their individual significance, there seems to be an intricate interplay between walking biomechanics and inflammation that could be pivotal in determining an individual’s susceptibility to developing OA [ 8 , 9 ] Specifically, using real-time gait biofeedback in participants post-ACLR to change their vGRF during walking will alter the levels of pro-inflammatory biomarkers and enzymes that break down cartilage [ 17 ], thus escalating the risk of chronic inflammation and joint damage [ 18 , 19 ] However, the exact nature of the interaction between biomechanics and chronic inflammation following ACLR remains unclear.…”

Can radiological findings detect neuropathic pain in patients with osteoarthritis of the knee undergoing surgery?

“…[7][8][9][10][11]21 To comprehensively assess knee tissue (articular cartilage, ligaments, bone, menisci, and fat tissue) in knee OA, the magnetic resonance imaging osteoarthritis knee score (MOAKS) has been validated and useful. [23][24][25][26][27] This study aimed to investigate whether possible NP in patients with knee OA undergoing knee surgeries is specific radiological findings of the knee joint using MOAKS. Identification of specific radiological findings resulting in NP has the potential to improve pain management, including pharmaceutical, physical, and surgical treatment, to provide pain relief and improve quality of life in patients with knee OA.…”