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Does patellar alignment or trochlear morphology predict worsening of patellofemoral disease within the first 5 years after anterior cruciate ligament reconstruction?
Univ British Columbia, Canada; Univ Delaware, DE USA; Erasmus MC, Netherlands.
La Trobe Univ, Australia.
La Trobe Univ, Australia.
Univ Delaware, DE USA; Northeastern Univ, MA 02115 USA.
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2019 (English)In: European Journal of Radiology, ISSN 0720-048X, E-ISSN 1872-7727, Vol. 113, p. 32-38Article in journal (Refereed) Published
Abstract [en]

Purpose: We described patellofemoral alignment and trochlear morphology at one and five years after anterior cruciate ligament reconstruction (ACLR), and evaluated the associations between alignment and trochlear morphology (at one year) and worsening patellofemoral osteoarthritis (OA) features by five years. We also evaluated the associations between alignment and morphology to self-reported pain and function (Knee injury and Osteoarthritis Outcome Score, KOOS) at five years. Materials and methods: In this longitudinal observational study, we followed 73 participants (mean age 29[9] years, 40% women) from one-to five-years after ACLR. Using MRI, we measured alignment and morphology, and scored cartilage and bone marrow lesions at both time points. We used mixed effects and linear regression models to achieve our stated aims. Results: Greater lateral patella displacement increased risk of cartilage worsening (Odds Ratio [95% CI]: 1.09 [1.01, 1.16]); while less lateral tilt (0.91 [0.83, 0.99]) and greater trochlear angle (0.88 [0.77, 1.00]) were protective. Greater medial trochlear inclination increased risk of bone marrow lesion worsening (1.12 [1.04, 1.19]); while greater trochlear angle was protective (0.80 [0.67, 0.96]). Greater lateral displacement was associated with worse self-reported KOOS sport and recreation scores (beta [95% CI]: -11.0 [-20.9, -1.2]) and quality of life scores (-10.5 [-20.4, -0.7]). Conclusions: Lateral displacement, lateral tilt, and morphology at 1 year post-ACLR altered the risk of worsening patellofemoral OA features four years later. Lateral displacement was the only measure associated with worse self-reported symptoms at five years. These findings may lead to novel treatment strategies for secondary prevention after ACLR.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2019. Vol. 113, p. 32-38
Keywords [en]
Anterior cruciate ligament reconstruction; Patellofemoral osteoarthritis; Magnetic resonance imaging; Patellar alignment; Trochlear morphology
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:liu:diva-156384DOI: 10.1016/j.ejrad.2019.01.033ISI: 000462586100005PubMedID: 30927957OAI: oai:DiVA.org:liu-156384DiVA, id: diva2:1305812
Note

Funding Agencies|Arthritis Australia; La Trobe Universitys Sport, Exercise and Rehabilitation Research Focus Area; Queensland Orthopaedic Physiotherapy Network; University of Melbourne; University of British Columbias Centre for Hip Health and Mobility (Society for Mobility and Health); Australian Endeavour Award Research Fellowship; Vanier Canada Graduate Scholarship (CIHR); NIH/NIGMS [U54-GM104941]; NIH/NIAMS [K23AR070913]; National Health and Medical Research Council (NHMRC) [GNT 1114296]; NHMRC Early Career Fellowship (Neil Hamilton Fairley Clinical Fellowship) [GNT 1121173]

Available from: 2019-04-18 Created: 2019-04-18 Last updated: 2019-04-18

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