title: Comparison of volumetric bone mineral density in the operated and contralateral knee after anterior cruciate ligament and reconstruction: A 1-year follow-up study using peripheral quantitative computed tomography.
abstract: The purpose of this study was to quantify changes in volumetric bone mineral density (vBMD) in the tibial plateau of the operated and contralateral leg measured using peripheral quantitative computed tomography (pQCT) before and 3, 6, and 12 months after anterior cruciate ligament (ACL) reconstruction. The ACL was reconstructed with a hamstring tendon autograft using press-fit fixation. pQCT measurements of the proximal tibia were obtained in 61 patients after ACL reconstruction, and total, cortical, and trabecular vBMD were calculated. vBMD in the operated leg decreased from baseline to 3 months (-12% [total], -11% [cortical], and -12.6% [trabecular]; p<0.001) and remained below baseline for 12 months after surgery (6 months: -9.5%, -9.4%, and -9.6%, p<0.001; 12 months: -8%, -5%, and -11%, p<0.001). vBMD in the contralateral leg was slightly reduced only 6 months after surgery. Including age and sex as covariates into the analysis did not affect the results. ACL reconstruction contributed to loss in bone mineral density within the first year after surgery. The role of factors such as time of weight-bearing, joint mechanics, post-traumatic inflammatory reactions, or genetic predisposition in modulating the development of posttraumatic knee osteoarthritis after ACL injury should be further elucidated.
authors.affiliation: Department of Orthopaedics, University Hospital Basel, Basel, Switzerland.|Division of Sport Science, University of Konstanz, Konstanz, Germany.
authors.forename: Annegret
authors.initials: A
authors.lastname: Mündermann
authors.affiliation: Division of Sport Science, University of Konstanz, Konstanz, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Payer
authors.affiliation: ARTICO Sport Clinic, Villingen-Schwenningen, Germany.
authors.forename: Gernot
authors.initials: G
authors.lastname: Felmet
authors.affiliation: Division of Sport Science, University of Konstanz, Konstanz, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Riehle
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000000981:diagnostic imaging* / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D012189:Retrospective Studies; D012737:Sex Factors; D013977:Tibia / Q000000981:diagnostic imaging* / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016474:Weight-Bearing; D055815:Young Adult
keywords: anterior cruciate ligament reconstruction; post-traumatic osteoarthritis pathway; press-fit fixation; volumetric bone mineral density