Prevalence of Early Knee Osteoarthritis Illness Among Various <scp>Patient‐Reported</scp> Classification Criteria After Anterior Cruciate Ligament Reconstruction

Harkey, Matthew S.; Baez, Shelby; Lewis, Jordan; Grindstaff, Terry L.; Hart, Joseph M.; Driban, Jeffrey B.; Schorfhaar, Andrew; Kuenze, Christopher

doi:10.1002/acr.24809

Cited by 15 publications

(5 citation statements)

References 27 publications

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“…Our novel findings identify early deficits in knee-related QOL of youth with a broad range of knee injuries compared with uninjured peers. At 6 months post-ACLR, youth have reported KOOS QOL scores (mean range 56-68), 3,4,33,34 but only one of these studies compared knee-related QOL between youth with and without an ACL rupture and found deficits. 3 Given that long-term impairments in knee-related QOL are common, 1,35,36 these early deficits should be addressed immediately after a knee injury.…”

Section: Discussionmentioning

confidence: 99%

Comparing Short-Term Knee-Related Quality of Life and Associated Clinical Outcomes Between Youth With and Without a Sport-Related Knee Injury

Losciale

Filbay

et al. 2023

Clinical Journal of Sport Medicine

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Objective: To compare short-term changes in knee-related quality of life (QOL) and associated clinical outcomes between youth with and without a sport-related knee injury. Design: Prospective cohort study. Setting: Sport medicine and physiotherapy clinics. Participants: Youth (11-19 years old) who sustained an intra-articular, sport-related knee injury in the past 4 months and uninjured youth of similar age, sex, and sport. Independent Variable: Injury history. Main Outcome Measures: Knee-related QOL (Knee injury and Osteoarthritis Outcome Score, KOOS), knee extensor and flexor strength (dynamometry), physical activity (accelerometer), fat mass index (FMI; bioelectrical impedance), and kinesiophobia (Tampa Scale for Kinesiophobia, TSK) were measured at baseline (within 4 months of injury) and at 6-month follow-up. Wilcoxon rank sum tests assessed between-group differences for all outcomes. Regression models assessed the association between injury history and outcome change (baseline to 6-month follow-up), considering sex. The influence of injury type, baseline values, and physiotherapy attendance was explored. Results: Participants' (93 injured youth, 73 uninjured control subjects) median age was 16 (range 11-20) years and 66% were female. Despite greater improvements in KOOS QOL scores (20; 95% confidence interval, 15-25), injured participants demonstrated deficits at 6-month followup (z 5 9.3, P , 0.01) compared with control subjects, regardless of sex. Similar findings were observed for knee extensor and flexor strength and TSK scores but not for physical activity or FMI. Lower baseline values were associated with greater outcome changes in injured youth. Conclusions: Youth have worse knee-related QOL, muscle strength, and kinesiophobia early after a sport-related knee injury than control subjects. Despite improvements, deficits persist 6 months later.

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Section: Discussionmentioning

confidence: 99%

Comparing Short-Term Knee-Related Quality of Life and Associated Clinical Outcomes Between Youth With and Without a Sport-Related Knee Injury

Losciale

Filbay

et al. 2023

Clinical Journal of Sport Medicine

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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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“…10 The Englund classification has also been applied to patients early after ACLR. 11,12 Recent investigations have explored the relationship between symptomatic knees and clinical outcomes, 12 and explored the utilization of these criteria in patients approximately 6-months post-ACLR. 11 However, to the authors' knowledge, there is limited evidence that has explored the relationship between osteoarthritis symptomology, health-related quality of life and psychological outcomes in people with a history of ACLR.…”

Section: Introductionmentioning

confidence: 99%

Health-Related Quality of Life and Psychological Outcomes in Participants with Symptomatic and Non-Symptomatic Knees after ACL Reconstruction

Hoch,

Swann,

Kleis

et al. 2024

International Journal of Sports Physical Therapy

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Background Individuals who sustain an ACL injury and undergo reconstruction (ACLR) are at risk for the development of osteoarthritis. Recent investigations have applied the Englund criteria to categorize people with a history of ACLR as someone with a symptomatic or asymptomatic knee. Purpose/Hypothesis The purpose of this study was to examine differences in health-related quality of life (HRQL) and psychological outcomes in people with a history of ACLR who were categorized as symptomatic or non-symptomatic by application of the Englund criteria. The authors’ hypothesized participants classified as symptomatic would have lower HRQL, increased fear-avoidance beliefs, and decreased resilience compared to participants classified as non-symptomatic. Study design Cross-sectional, survey Methods Participants at least one-year after ACLR were recruited for the study and completed the Tegner Activity Scale, the Brief Resilience Scale (BRS), the modified Disablement in the Physically Active Scale (mDPA), and the Fear-Avoidance Belief Questionnaire (FABQ) at one time-point. Descriptive statistics were summarized using median [interquartile range] and differences between groups were examined using separate Mann-Whitney U tests. Results Participants with symptomatic knees had a significantly higher BMI (24.8 [6.4]) than the non-symptomatic group (21.2 [4.3], p=0.013). Participants in the symptomatic group had worse HRQL on the physical subscale (12.5 [16.3] vs. 0.0 [2.5], p<0.001) and mental subscale (2.0 [1] vs. 0.0 [1], p=0.031), higher scores on the FABQ-Sport (14.5 [11] vs. 0.0 [6], p<0.001) and FABQ-Physical Activity (20 [24] vs. 1 [4], p<0.001) and less resilience (3.7[0.42] vs. 4.0 [0.83], p=0.028) compared to those participants in the non-symptomatic group. There were no differences in current physical activity (p=0.285) or change in physical activity (p=0.124) levels between the two groups. Conclusions This series of differences may represent a cascade of events that can continue to negatively impact health outcomes across the lifespan for individuals with a history of ACLR. Future research should consider longitudinal investigations of these outcomes after injury and throughout the post-surgical and post-rehabilitation timeframe. Level of Evidence Level 3b

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Prevalence of Early Knee Osteoarthritis Illness Among Various Patient‐Reported Classification Criteria After Anterior Cruciate Ligament Reconstruction

Cited by 15 publications

References 27 publications

Comparing Short-Term Knee-Related Quality of Life and Associated Clinical Outcomes Between Youth With and Without a Sport-Related Knee Injury

Comparing Short-Term Knee-Related Quality of Life and Associated Clinical Outcomes Between Youth With and Without a Sport-Related Knee Injury

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

Health-Related Quality of Life and Psychological Outcomes in Participants with Symptomatic and Non-Symptomatic Knees after ACL Reconstruction

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