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Slower Walking Speed Is Related to Early Femoral Trochlear Cartilage Degradation After ACL Reconstruction |
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| Authors: | Jacob J Capin Jack R Williams Kelsey Neal Ashutosh Khandha Laura Durkee Naoaki Ito Joshua J Stefanik Lynn Snyder-Mackler Thomas S Buchanan |
| Institution: | 1. Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Mail Stop C244, 13121 E 17th Ave, Aurora, Colorado, 80045;2. Department of Mechanical Engineering, University of Delaware, Newark, Delaware;3. Department of Biomedical Engineering, University of Delaware, Newark, Delaware;4. Athletic Training Education Program, Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware;5. Biomechanics and Movement Science Program, College of Health Sciences, University of Delaware, Newark, Delaware;6. Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts;7. Department of Biomedical Engineering, University of Delaware, Newark, Delaware
Biomechanics and Movement Science Program, College of Health Sciences, University of Delaware, Newark, Delaware Department of Physical Therapy, University of Delaware, Newark, Delaware Delaware Rehabilitation Institute, University of Delaware, Newark, Delaware;8. Department of Mechanical Engineering, University of Delaware, Newark, Delaware Department of Biomedical Engineering, University of Delaware, Newark, Delaware Delaware Rehabilitation Institute, University of Delaware, Newark, Delaware |
| Abstract: | Post-traumatic patellofemoral osteoarthritis (OA) is prevalent after anterior cruciate ligament reconstruction (ACLR) and early cartilage degradation may be especially common in the femoral trochlear cartilage. Determining the presence of and factors associated with early femoral trochlear cartilage degradation, a precursor to OA, is a critical preliminary step in identifying those at risk for patellofemoral OA development and designing interventions to combat the disease. Early cartilage degradation can be detected using quantitative magnetic resonance imaging measures, such as tissue T2 relaxation time. The purposes of this study were to (i) compare involved (ACLR) versus uninvolved (contralateral) femoral trochlear cartilage T2 relaxation times 6 months after ACLR, and (ii) determine the relationship between walking speed and walking mechanics 3 months after ACLR and femoral trochlear cartilage T2 relaxation times 6 months after ACLR. Twenty-six individuals (age 23 ± 7 years) after primary, unilateral ACLR participated in detailed motion analyses 3.3 ± 0.6 months after ACLR and quantitative magnetic resonance imaging 6.3 ± 0.5 months after ACLR. There were no limb differences in femoral trochlear cartilage T2 relaxation times. Slower walking speed was related to higher (worse) femoral trochlear cartilage T2 relaxation times in the involved limb (Pearson's r: −0.583, p = 0.002) and greater interlimb differences in trochlear T2 relaxation times (Pearson's r: −0.349, p = 0.080). Walking mechanics were weakly related to trochlear T2 relaxation times. Statement of clinical significance: Slower walking speed was by far the strongest predictor of worse femoral trochlear cartilage health, suggesting slow walking speed may be an early clinical indicator of future patellofemoral OA after ACLR. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:645–652, 2020 |
| Keywords: | anterior cruciate ligament reconstruction gait mechanics magnetic resonance imaging patellofemoral osteoarthritis trochlear cartilage |