title: The effects of femoral graft placement on cartilage thickness after anterior cruciate ligament reconstruction.
abstract: 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.
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States.
authors.forename: Eziamaka C
authors.initials: EC
authors.lastname: Okafor
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States.
authors.forename: Gangadhar M
authors.initials: GM
authors.lastname: Utturkar
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, United States.
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Widmyer
authors.affiliation: Department of Orthopaedics, University of Pittsburgh Medical Center, United States.
authors.forename: Ermias S
authors.initials: ES
authors.lastname: Abebe
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States.
authors.forename: Amber T
authors.initials: AT
authors.lastname: Collins
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States; Durham VA Medical Center, Durham, NC, United States.
authors.forename: Dean C
authors.initials: DC
authors.lastname: Taylor
authors.affiliation: Department of Radiology, Duke University Medical Center, United States.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Spritzer
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States.
authors.forename: C T
authors.initials: CT
authors.lastname: Moorman
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States; Durham VA Medical Center, Durham, NC, United States.
authors.forename: William E
authors.initials: WE
authors.lastname: Garrett
authors.affiliation: Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University Medical Center, 375 MSRB, Box 3093, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, United States. Electronic address: lou.defrate@duke.edu.
authors.forename: Louis E
authors.initials: LE
authors.lastname: DeFrate
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D002356:Cartilage / Q000503:physiopathology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007717:Knee / Q000503:physiopathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement; D010003:Osteoarthritis / Q000517:prevention & control; D019651:Plastic Surgery Procedures; D055815:Young Adult
keywords: ACL; Imaging; Kinematics; MRI; Mechanics; Osteoarthritis