Kyoung Ho Yoon1, Dae Hyun Tak1, Taeg Su Ko1, Sang Eon Park1, Juhyun Nam1, Sang Hak Lee2. 1. Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea. 2. Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea. Electronic address: sangdory@hanmail.net.
Abstract
BACKGROUND: The purpose of this study was to evaluate the prevalence and risk factor of cartilage degeneration of the patellofemoral joint (PFJ) that was diagnosed by second-look arthroscopy. METHODS: One-hundred and seven patients who underwent ACL reconstruction were evaluated by preoperative MRI, postoperative MRI and second-look arthroscopy. Severity of infrapatellar fat pad (IPFP) fibrosis was evaluated by MRI at an average of 26months after ACL reconstruction. Cartilage degeneration was assessed by second-look arthroscopy at 29months. RESULTS: Twenty-five patients (24.0%) showed cartilage degeneration of the PFJ in second-look arthroscopy. Patients were divided into three groups according to severity of IPFP fibrosis of postoperative MRI (i.e. Group A, focal and incomplete band fibrosis, n=69; Group B, complete band fibrosis, n=31; and Group C, diffuse and infiltrated fibrosis, n=7). Cartilage degeneration of the PFJ was significantly worsened with more fibrosis formation of the IPFP (P<0.001). Other factors for instabilities (BMI, age, concomitant meniscal procedure, time from injury to reconstruction, severity of IPFP fibrosis at preoperative MRI and clinical scores) were not correlated with cartilage degeneration of the PFJ. The multivariate logistic regression analysis of degeneration of the PFJ after ACL reconstruction identified more severe fibrosis tissue formation of the IPFP and initial cartilage defect as significant predictors. CONCLUSIONS: More extensive fibrosis of the IPFP and initial cartilage defect may be related to further degenerative changes of the PFJ. Other factors did not affect cartilage degeneration of the PFJ, although the muscle strength, the individual activity level or the rehabilitation protocol was not evaluated in the short-term follow-up period.
BACKGROUND: The purpose of this study was to evaluate the prevalence and risk factor of cartilage degeneration of the patellofemoral joint (PFJ) that was diagnosed by second-look arthroscopy. METHODS: One-hundred and seven patients who underwent ACL reconstruction were evaluated by preoperative MRI, postoperative MRI and second-look arthroscopy. Severity of infrapatellar fat pad (IPFP) fibrosis was evaluated by MRI at an average of 26months after ACL reconstruction. Cartilage degeneration was assessed by second-look arthroscopy at 29months. RESULTS: Twenty-five patients (24.0%) showed cartilage degeneration of the PFJ in second-look arthroscopy. Patients were divided into three groups according to severity of IPFP fibrosis of postoperative MRI (i.e. Group A, focal and incomplete band fibrosis, n=69; Group B, complete band fibrosis, n=31; and Group C, diffuse and infiltrated fibrosis, n=7). Cartilage degeneration of the PFJ was significantly worsened with more fibrosis formation of the IPFP (P<0.001). Other factors for instabilities (BMI, age, concomitant meniscal procedure, time from injury to reconstruction, severity of IPFP fibrosis at preoperative MRI and clinical scores) were not correlated with cartilage degeneration of the PFJ. The multivariate logistic regression analysis of degeneration of the PFJ after ACL reconstruction identified more severe fibrosis tissue formation of the IPFP and initial cartilage defect as significant predictors. CONCLUSIONS: More extensive fibrosis of the IPFP and initial cartilage defect may be related to further degenerative changes of the PFJ. Other factors did not affect cartilage degeneration of the PFJ, although the muscle strength, the individual activity level or the rehabilitation protocol was not evaluated in the short-term follow-up period.
Authors: Joanna M Stephen; Ran Sopher; Sebastian Tullie; Andrew A Amis; Simon Ball; Andy Williams Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-04-20 Impact factor: 4.342
Authors: U Heilmeier; K Mamoto; K Amano; B Eck; M Tanaka; J A Bullen; B J Schwaiger; J L Huebner; T V Stabler; V B Kraus; C B Ma; T M Link; X Li Journal: Osteoarthritis Cartilage Date: 2019-09-14 Impact factor: 6.576