Females who have undergone anterior cruciate ligament reconstruction exhibit altered patellofemoral joint contact area and alignment

IF 1.4 3区 医学 Q4 ENGINEERING, BIOMEDICAL
Thomas Demirjian , Richard Souza , George Salem , John Crues III , Christopher M. Powers
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Abstract

Background

Lateral patella tilt and displacement have been reported to be associated with increased risk for early-onset osteoarthritis post ACL reconstruction. It is conceivable that altered patella alignment may expose these individuals to excessive joint stress owing to a reduction in contact area between the patella and trochlear surface of the femur. Therefore, our study objectives were: 1) to compare patellofemoral joint contact area and patellar alignment between females post-ACL reconstruction and healthy controls, and 2) to assess associations between measures of patellar alignment and contact area.

Methods

Forty females between the ages of 18–35 (20 post-ACL reconstruction, 20 matched controls) underwent MR imaging of the patellofemoral joint at 0°, 20°, 40°, and 60° of knee flexion under loaded conditions (35 % bodyweight). Patellofemoral joint contact area, lateral patella tilt and lateral patella displacement were compared between groups and knee flexion angles using repeated measures analysis of variance tests. Pearson correlations evaluated associations between patella alignment and contact area at each knee flexion angle.

Findings

Compared to the control group, females post ACL reconstruction exhibited significantly reduced contact area (differences ranging from 21.6 % to 29.1 %), and elevated lateral patella tilt (differences ranging from 3.7° to 4.9°). No differences in lateral patellar displacement were observed. Lateral patellar tilt was negatively correlated with contact area across all knee angles (r-values ranging from −0.32 to −0.66).

Interpretation

Reduced contact area highlights a potential mechanism by which patellar alignment may be contributory to early cartilage changes post ACL reconstruction.
接受前交叉韧带重建的女性表现出髌骨股骨关节接触面积和排列的改变
背景:据报道,髌骨外侧倾斜和移位与ACL重建后早发性骨关节炎的风险增加有关。可以想象,由于髌骨与股骨滑车表面之间的接触面积减少,改变的髌骨排列可能使这些个体暴露于过度的关节应力。因此,我们的研究目标是:1)比较前交叉韧带重建后的女性与健康对照者的髌骨-股骨关节接触面积和髌骨对中值;2)评估髌骨对中值和接触面积之间的关系。方法40名年龄在18-35岁之间的女性(20名前交叉韧带重建后,20名对照组)在负重条件下(体重的35%)对膝关节屈曲0°、20°、40°和60°的髌骨股骨关节进行MR成像。采用重复测量分析方差检验比较各组髌骨关节接触面积、髌骨外侧倾斜、髌骨外侧位移及膝关节屈曲角度。Pearson相关性评估髌骨对齐和每个膝关节屈曲角度接触面积之间的关系。结果:与对照组相比,女性前交叉韧带重建后的接触面积明显减少(差异范围从21.6%到29.1%),外侧髌骨倾斜升高(差异范围从3.7°到4.9°)。观察到外侧髌骨移位无差异。髌骨外侧倾斜与所有膝关节角度的接触面积呈负相关(r值为- 0.32至- 0.66)。解释:接触面积减少强调了髌韧带排列可能有助于前交叉韧带重建后早期软骨改变的潜在机制。
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来源期刊
Clinical Biomechanics
Clinical Biomechanics 医学-工程:生物医学
CiteScore
3.30
自引率
5.60%
发文量
189
审稿时长
12.3 weeks
期刊介绍: Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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