Relevant traumatic injury of the knee joint—MRI follow-up after 7–10 years (original) (raw)
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Journal of Biomechanics, 2015
The objective of this study was to induce anterior cruciate ligament (ACL) and meniscal damage, via a single tibiofemoral compressive impact, in order to document articular cartilage and meniscal changes post impact. Tibiofemoral joints of Flemish Giant rabbits were subjected to a single blunt impact that ruptured the ACL and produced acute meniscal damage. Animals were allowed unrestricted cage activity for 12 weeks before euthanasia. India ink analysis of the articular cartilage revealed higher degrees of surface damage on the impacted tibias (p=0.018) and femurs (p<0.0001) compared to controls. Chronic meniscal damage was most prevalent in the medial central and medial posterior regions. Mechanical tests revealed an overall 19.4% increase in tibial plateau cartilage thickness (p=0.026), 34.8% increase in tibial plateau permeability (p=0.054), 40.8% increase in femoral condyle permeability (p=0.029), and 20.1% decrease in femoral condyle matrix modulus (p=0.012) in impacted joints compared to controls. Both the instantaneous and equilibrium moduli of the lateral and medial menisci were decreased compared to control (p<0.02). Histological analyses revealed significantly increased presence of fissures in the medial femur (p = 0.036). In both the meniscus and cartilage there was a significant decrease in GAG coverage for the impacted limbs. Based on these results it is clear that an unattended combined meniscal and ACL injury results in significant changes to the soft tissues in this experimental joint 12 weeks post injury. Such changes are consistent with a clinical description of mid to late stage PTOA of the knee.
Frontiers in Bioengineering and Biotechnology, 2022
Post-traumatic osteoarthritis (PTOA) is a debilitating disease that is a result of a breakdown of knee joint tissues following traumatic impact. The interplay of how these tissues influence each other has received little attention because of complex interactions. This study was designed to correlate the degeneration of the menisci, cartilage and subchondral bone following an acute traumatic event that resulted in anterior cruciate ligament (ACL) and medial meniscus tears. We used a well-defined impact injury animal model that ruptures the ACL and tears the menisci. Subsequently, the knee joints underwent ACL reconstruction and morphological analyses were performed on the menisci, cartilage and subchondral bone at 1-, 3- and 6-months following injury. The results showed that the morphological scores of the medial and lateral menisci worsened with time, as did the tibial plateau and femoral condyle articular cartilage scores. The medial meniscus was significantly correlated to the med...
Journal of Orthopaedic Research, 2016
ABSTRACTThe objective of this study was to compare longitudinal results from two models of combined anterior cruciate ligament (ACL) and meniscal injury. A modified ACL transection (mACLT) model and a traumatic impact (ACLF) model were used to create an ACL rupture and acute meniscal damage in a Flemish Giant animal model. The animals were euthanized at time points of 4, 8, or 12 weeks. The menisci were assessed for equilibrium and instantaneous compressive modulus, as well as glycosaminoglycan (GAG) coverage. The articular cartilage was mechanically assessed for thickness, matrix modulus, fiber modulus, and permeability. Articular cartilage GAG coverage, fissuring, tidemark integrity, and subchondral bone thickness were measured. Both models resulted in damage indicative of osteoarthritis, including decreased meniscal mechanics and GAG coverage, increased permeability and fissuring of articular cartilage, and decreased GAG coverage. The mACLT model had an early and lasting effect o...
Journal of Orthopaedic Research, 2019
Combined injury to the anterior cruciate ligament (ACL) and meniscus is associated with earlier onset and increased rates of post traumatic osteoarthritis (PTOA) compared to isolated ACL injury. However, little is known about the initial changes in joint structure associated with these different types of trauma. We hypothesized that trauma to the ACL and lateral meniscus has an immediate effect on morphometry of the articular cartilage and meniscus about the entire tibial plateau that is more pronounced than an ACL tear without meniscus injury. Subjects underwent MRI scanning soon after injury and prior to surgery. Those that suffered injury to the ACL and lateral meniscus underwent changes in the lateral compartment (increases in the posterior-inferior directed slopes of the articular cartilage surface, and the wedge angle of the posterior horn of the meniscus) and medial compartment (the cartilage-to-bone height decreased in the region located under the posterior horn of the meniscus, and the thickness of cartilage increased and decreased in the mid and posterior regions of the plateau, respectively). Subjects that suffered an isolated ACL tear did not undergo the same magnitude of change to these articular structures. A majority of the changes in morphometry occurred in the lateral compartment of the knee; however, change in the medial compartment of the knee with a normal appearing meniscus also occurred.
The American journal of sports medicine
In this study, 130 consecutive patients with anterior cruciate ligament insufficiency who were undergoing ligament reconstruction underwent arthroscopic examination at the time of reconstruction, and any loss of meniscal or chondral integrity was documented in a systematic fashion. In these patients, a greater proportion of the medial meniscus was lost compared with the lateral meniscus (16% versus 5%). On average, 6 cm2 of the articular cartilage was damaged (5.2 cm2) or lost (0.8 cm2), with the area of damage and loss greatest on the medial femoral condyle. Patients whose injuries had occurred more than 2 years before the examination had more than sixfold greater cartilage loss and damage compared with those whose injuries had occurred within the past 2 months. Meniscal loss was associated with a threefold increase in cartilage damage or loss. The group of patients with meniscal loss whose initial anterior cruciate ligament injury occurred more than 2 years before examination exhi...
Arthritis and Rheumatism, 2002
ObjectiveTo evaluate the rate of progression of cartilage loss in the knee joint using magnetic resonance imaging (MRI) and to evaluate potential risk factors for more rapid cartilage loss.To evaluate the rate of progression of cartilage loss in the knee joint using magnetic resonance imaging (MRI) and to evaluate potential risk factors for more rapid cartilage loss.MethodsWe evaluated baseline and followup MRIs of the knees in 43 patients (minimum time interval of 1 year, mean 1.8 years, range 52–285 weeks). Cartilage loss was graded in the anterior, central, and posterior regions of the medial and lateral knee compartments. Knee joints were also evaluated for other pathology. Data were analyzed using analysis of variance models.We evaluated baseline and followup MRIs of the knees in 43 patients (minimum time interval of 1 year, mean 1.8 years, range 52–285 weeks). Cartilage loss was graded in the anterior, central, and posterior regions of the medial and lateral knee compartments. Knee joints were also evaluated for other pathology. Data were analyzed using analysis of variance models.ResultsPatients who had sustained meniscal tears showed a higher average rate of progression of cartilage loss (22%) than that seen in those who had intact menisci (14.9%) (P ≤ 0.018). Anterior cruciate ligament (ACL) tears had a borderline significant influence (P ≤ 0.06) on the progression of cartilage pathology. Lesions located in the central region of the medial compartment were more likely to progress to more advanced cartilage pathology (progression rate 28%; P ≤ 0.003) than lesions in the anterior (19%; P ≤ 0.564) and posterior (17%; P ≤ 0.957) regions or lesions located in the lateral compartment (average progression rate 15%; P ≤ 0.707). Lesions located in the anterior region of the lateral compartment showed less progression of cartilage degradation (6%; P ≤ 0.001). No specific grade of lesion identified at baseline had a predilection for more rapid cartilage loss (P ≤ 0.93).Patients who had sustained meniscal tears showed a higher average rate of progression of cartilage loss (22%) than that seen in those who had intact menisci (14.9%) (P ≤ 0.018). Anterior cruciate ligament (ACL) tears had a borderline significant influence (P ≤ 0.06) on the progression of cartilage pathology. Lesions located in the central region of the medial compartment were more likely to progress to more advanced cartilage pathology (progression rate 28%; P ≤ 0.003) than lesions in the anterior (19%; P ≤ 0.564) and posterior (17%; P ≤ 0.957) regions or lesions located in the lateral compartment (average progression rate 15%; P ≤ 0.707). Lesions located in the anterior region of the lateral compartment showed less progression of cartilage degradation (6%; P ≤ 0.001). No specific grade of lesion identified at baseline had a predilection for more rapid cartilage loss (P ≤ 0.93).ConclusionMRI can detect interval cartilage loss in patients over a short period (<2 years). The presence of meniscal and ACL tears was associated with more rapid cartilage loss. Cartilage lesions located in the central region of the medial compartment showed more rapid progression of cartilage loss than cartilage lesions in the anterior and posterior portions of the medial compartment. The findings in this study suggest that patients entering clinical trials investigating antiarthritis regimens may need to be randomized based on location of the lesion.MRI can detect interval cartilage loss in patients over a short period (<2 years). The presence of meniscal and ACL tears was associated with more rapid cartilage loss. Cartilage lesions located in the central region of the medial compartment showed more rapid progression of cartilage loss than cartilage lesions in the anterior and posterior portions of the medial compartment. The findings in this study suggest that patients entering clinical trials investigating antiarthritis regimens may need to be randomized based on location of the lesion.
Knee Surgery, Sports Traumatology, Arthroscopy, 2012
Purpose To analyze the morphological change in the cartilage of the knee after anterior cruciate ligament (ACL) injury by comparing with that of the intact contralateral knee. Methods A total of 22 participants (12 male and 10 female patients) who had unilateral ACL injury underwent MRI scan of both the injured and intact contralateral knees. Sagittal plane images were segmented using a modeling software to determine cartilage volume and cartilage thickness in each part of the knee cartilage that were compared between the ACL-injured and the intact contralateral knees. Furthermore, the male and female patients' data were analyzed in subgroups. Results The ACL-injured knees had statistically significant lower total knee cartilage volume than the intact contralateral knees (P = 0.0020), but had similar mean thickness of total knee cartilage (not significant: n.s.). In the male subgroup, there was no significant difference in cartilage volume and thickness between normal and ACLinjured knees. In the female subgroup, the ACL-injured knees demonstrated statistically significant difference in total knee cartilage volume (P = 0.0004) and thickness (P = 0.0024) compared with the normal knees. The percentage change in the cartilage thickness in women was significantly greater than that in men. Conclusion Cartilage volume was significantly smaller in the ACL-injured knees than in the contralateral intact knees in this cohort. Women tended to display greater cartilage volume and thickness change after ACL injury than men. These findings indicated that women might be more susceptible to cartilage alteration after ACL injuries. Level of evidence III.