The effects of femoral graft placement on cartilage thickness after anterior cruciate ligament reconstruction
The effects of femoral graft placement on cartilage thickness after anterior cruciate ligament reconstruction
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DOI：
10.1016/j.jbiomech.2013.10.003
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发表时间：
2014-01-03
影响因子：
2.4
通讯作者：
DeFrate, Louis E.
中科院分区：
文献类型：
--
作者：
Okafor, Eziamaka C.;Utturkar, Gangadhar M.;DeFrate, Louis E.
关节活动度改变被认为是ACL重建后骨关节炎长期发展的一个促成因素。虽然许多研究已经量化了ACL损伤和重建后的膝关节运动学，但表征膝关节运动改变对软骨厚度分布影响的体内数据有限。因此，本研究的目的是比较两组ACL重建患者的软骨厚度分布：一组受试者接受了导致关节运动异常的非解剖重建，另一组受试者接受了更接近恢复正常膝关节运动的解剖放置移植物。采用高分辨率MR成像对10例解剖型移植物放置患者（平均随访：20个月）和12例非解剖型移植物放置患者（平均随访：18个月）进行扫描。这些图像用于生成每例患者双膝的3D网格模型。将手术和对侧膝关节模型彼此配准，并使用网格采样系统对软骨厚度进行部位特异性比较。非解剖型移植物放置组的患者表现出相对于完整膝关节，手术膝关节内侧髁间窝软骨厚度沿着显著降低（8%）。在解剖型移植物放置组中，未观察到显著变化。这些发现表明，ACL损伤后恢复正常的膝关节运动可能有助于减缓退变的进展。因此，移植物放置可能对ACL重建后骨关节炎的发展有重要意义。(C)2013爱思唯尔有限公司保留所有权利。
Altered joint motion has been thought to be a contributing factor in the long-term development of osteoarthritis after ACL reconstruction. While many studies have quantified knee kinematics after ACL injury and reconstruction, there is limited in vivo data characterizing the effects of altered knee motion on cartilage thickness distributions. Thus, the objective of this study was to compare cartilage thickness distributions in two groups of patients with ACL reconstruction: one group in which subjects received a non-anatomic reconstruction that resulted in abnormal joint motion and another group in which subjects received an anatomically placed graft that more closely restored normal knee motion. Ten patients with anatomic graft placement (mean follow-up: 20 months) and 12 patients with non-anatomic graft placement (mean follow-up: 18 months) were scanned using high-resolution MR imaging. These images were used to generate 3D mesh models of both knees of each patient. The operative and contralateral knee models were registered to each other and a grid sampling system was used to make site-specific comparisons of cartilage thickness. Patients in the non-anatomic graft placement group demonstrated a significant decrease in cartilage thickness along the medial intercondylar notch in the operative knee relative to the intact knee (8%). In the anatomic graft placement group, no significant changes were observed. These findings suggest that restoring normal knee motion after ACL injury may help to slow the progression of degeneration. Therefore, graft placement may have important implications on the development of osteoarthritis after ACL reconstruction. (C) 2013 Elsevier Ltd. All rights reserved.