title: Knee cartilage assessment with MRI (dGEMRIC) and subjective knee function in ACL injured copers: a cohort study with a 20 year follow-up.
abstract: OBJECTIVE
  To assess knee cartilage quality and subjective knee function, 20 years after injury in anterior cruciate ligament (ACL) injured copers.
  
  
  METHODS
  We examined 32 knees using delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC), 20 years after a complete ACL tear. Only subjects who had coped with the ACL injury without ACL reconstruction (ACLR), and who presented without radiographic signs of osteoarthritis (OA) at an earlier 16-year follow-up, were included in this study. The quality of the central weight-bearing parts of the medial and lateral femoral cartilage was estimated with dGEMRIC (T1Gd). These results were compared with corresponding results in 24 healthy individuals, and with the subjects' self-reported subjective knee function using the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire.
  
  
  RESULTS
  The values of T1Gd in the medial and lateral femoral cartilage of the study group (mean (95% CI)), were 404 (385-423) and 427 (399-455) ms, not statistically different from those of the healthy reference group (P = 0.065 and 0.31). The subjective knee function 20 years after the injury, according to the five domains of the KOOS score, was good, with a mean score of 90 ± 11. Values of T1Gd for the medial femoral cartilage were correlated with the KOOS subgroup QOL (P = 0.021, Pearson correlation).
  
  
  CONCLUSIONS
  Subjects who have managed to cope with their ACL injury for 20 years with sustained good subjective knee function also seem to have knee cartilage of good quality, with T1Gd values not very different from a healthy reference group.
authors.affiliation: Department of Orthopaedics, Clinical Sciences, Malmö, Lund University, Sweden. Electronic address: paul.neuman@skane.se.
authors.forename: P
authors.initials: P
authors.lastname: Neuman
authors.affiliation: Department of Orthopaedics, Clinical Sciences, Malmö, Lund University, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Owman
authors.affiliation: Department of Radiology, Clinical Sciences, Malmö, Lund University, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Müller
authors.affiliation: Department of Orthopaedics, Clinical Sciences, Malmö, Lund University, Sweden; Clinical Epidemiology Research & Training Unit, Boston University School of Medicine, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Englund
authors.affiliation: Department of Orthopaedics, Clinical Sciences, Malmö, Lund University, Sweden.
authors.forename: C J
authors.initials: CJ
authors.lastname: Tiderius
authors.affiliation: Department of Orthopaedics, Clinical Sciences, Malmö, Lund University, Sweden.
authors.forename: L E
authors.initials: LE
authors.lastname: Dahlberg
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D002358:Cartilage, Articular / Q000473:pathology*; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007718:Knee Injuries / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation; D007719:Knee Joint / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020127:Recovery of Function; D057566:Self Report
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Anterior cruciate ligament injury; Knee; MRI; Meniscus injury; Osteoarthritis; dGEMRIC