Less knee joint loading correlated with early knee OA after ACL reconstruction

Patients with early radiographic evidence of knee osteoarthritis 5 years after ACL reconstruction had lower knee adduction moments and medial compartment joint contact forces when walking compared to patients with no such evidence of osteoarthritis, according to study results.

by Monica Jaramillo, Healio Orthopedics Today February 18, 2016.

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Researchers evaluated 22 patients with a complete, unilateral ACL injury and performed a gait analysis before and after preoperative rehabilitation. Gait analysis also was performed after ACL reconstruction (ACLR) at 6 months, 1 year and 2 years.

Investigators created an electromyographically driven musculoskeletal model, and used surface elctromyographic and knee biochemical data to estimate knee joint contact forces. Five years after ACLR, patients underwent radiographic testing. Patients with radiographic evidence of osteoarthritis (OA) and those without OA were compared with regard to differences in knee joint kinetics and contact forces.

Results showed patients with OA compared to patients without the condition walked with a lower peak knee adduction moment, and inter-limb differences between the groups were significant. After preoperative rehabilitation, patients with OA had improvement in asymmetric peak frontal plane moments; however 6 months after ACLR, the OA and control groups showed significant differences for this measure.

At baseline, the OA group compared with the control group had lower knee adduction moment impulse in the involved limb. At 6 months and 1 year, there were large differences between the groups with regard to peak medial compartment contact forces in the involved limb, according to researchers.

Source Healio Orthopedics Today

Decreased Knee Joint Loading Associated With Early Knee Osteoarthritis After Anterior Cruciate Ligament Injury, Wellsandt E, Gardinier ES, Manal K, Axe MJ, Buchanan TS, Snyder-Mackler L. Am J Sports Med. 2016 Jan;44(1):143-51. doi: 10.1177/0363546515608475. Epub 2015 Oct 22.

Medial Tibiofemoral Joint Contact Force Unloading Associated with Early Knee Osteoarthritis after ACL Injury and Reconstruction, Elizabeth Wellsandt DPT, Emily S. Gardinier MS, Kurt Manal PhD, Michael Axe MD, Thomas S. Buchanan PhD, Lynn Snyder-Mackler PT ScD SCS ATC FAPTA. Orthopedic Research Society 2014 Annual Meeting, Poster No: 1663

Post-traumatic osteoarthritis after ACL injury, Racine J, Aaron RK. R I Med J (2013). 2014 Nov 3;97(11):25-8.

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