MRI volume and signal intensity of ACL graft predict clinical, functional, and patient-oriented outcome measures after ACL reconstruction.

MRI volume and signal intensity of ACL graft predict clinical, functional, and patient-oriented outcome measures after ACL reconstruction.
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DOI:
10.1177/0363546514561435
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发表时间:
2015-03
期刊:
The American journal of sports medicine
影响因子:
--
通讯作者:
Fleming BC
Fleming BC
中科院分区:
其他
文献类型:
--
作者:
Biercevicz AM;Akelman MR;Fadale PD;Hulstyn MJ;Shalvoy RM;Badger GJ;Tung GA;Oksendahl HL;Fleming BC

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临床、功能和以患者为导向的结局通常用于评价ACL损伤后的治疗效果;然而,这些评价技术并不直接测量愈合过程中发生的生物力学变化。为了确定移植物体积和信号强度(SI)的磁共振(MR)图像衍生参数是否已用于预测生物力学(即,动物模型中移植物的结构特性),与ACL重建后3年和5年患者中常用的临床(前后(AP)膝关节松弛)、功能(单腿跳跃)和患者导向结局指标(KOOS)相关。描述性实验室研究使用正在进行的ACL重建临床试验中招募的参与者子集,在3年和5年随访时评估AP膝关节松弛、单腿跳跃试验和KOOS。在每次访视时收集3-D T1加权MR图像。确定愈合移植物的体积和SI中位数,并将其用作多元回归线性模型中的预测因子,以预测传统的结局指标。在多元线性回归模型中,移植物体积结合SI中位数预测了3年和5年随访访视时的单腿跳跃试验(分别为R2=.40,p=.008和R2=.62,p=.003)。5年随访时,KOOS生活质量(R2=.49,p=.012)、运动功能(R2=.37,p=.048)、疼痛(R2=.46,p=.017)和症状(R2=.45,p=.021)分项评分的结果相似,尽管这些变量在3年时不显著。5年随访时AP膝关节松弛的多元线性回归模型接近显著性(R2=.36,p=.088)。用于预测动物模型中移植物的离体生物力学特性的MR参数(体积和中位数SI)能够预测3年和5年随访时患者的临床或体内结局指标。
Clinical, functional and patient-oriented outcomes are commonly used to evaluate the efficacy of treatments following ACL injury; however, these evaluation techniques do not directly measure the biomechanical changes that occur with healing. To determine if the magnetic resonance (MR) image-derived parameters of graft volume and signal intensity (SI), which have been used to predict the biomechanical (i.e., structural properties) of the graft in animal models, correlate with commonly used clinical (anteroposterior (AP) knee laxity), functional (1-leg hop) and patient-oriented outcome measures (KOOS) in patients 3- and 5-years after ACL reconstruction. Descriptive Laboratory Study Using a subset of participants enrolled in an ongoing ACL reconstruction clinical trial, AP knee laxity, 1-legged hop test, and KOOS were assessed at 3- and 5-year follow-up. 3-D T1-weighted MR images were collected at each visit. Both the volume and median SI of the healing graft were determined and used as predictors in a multiple regression linear model to predict the traditional outcome measures. Graft volume combined with median SI in a multiple linear regression model predicted 1-legged hop test at both the 3-year and 5-year follow-up visits (R2=.40, p=.008 and R2=.62, p=.003, respectively). Similar results were found with 5-year follow up for the KOOS quality of life (R2=.49, p=.012), sport_function (R2=.37, p=.048), pain (R2=.46, p=.017) and symptoms (R2=.45, p=.021) sub-scores, though these variables were not significant at 3 years. The multiple linear regression model for AP knee laxity at 5-year follow-up approached significance (R2=.36, p=.088). The MR parameters (volume and median SI) used to predict ex vivo biomechanical properties of the graft in an animal model have the ability to predict clinical or in vivo outcome measures in patients at 3- and 5-year follow-up.
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