Matthew P Ithurburn1,2,3, Andrew M Zbojniewicz4,5, Staci Thomas6, Kevin D Evans2, Michael L Pennell7, Robert A Magnussen3,8, Mark V Paterno6,9, Laura C Schmitt10,11,12. 1. Department of Physical Therapy and Center for Exercise Medicine, University of Alabama at Birmingham, SHPB 386, 1720 2nd Avenue South, Birmingham, AL, USA. 2. School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Columbus, OH, USA. 3. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 4. Advanced Radiology Services, 3264 North Evergreen Drive, Grand Rapids, MI, USA. 5. Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 6. Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 10001, Cincinnati, OH, USA. 7. Division of Biostatistics, College of Public Health, The Ohio State University, 250 Cunz Hall, 1841 Neil Avenue, Columbus, OH, USA. 8. Department of Orthopaedics, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, USA. 9. Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue MLC 10001, Cincinnati, OH, USA. 10. School of Health and Rehabilitation Sciences, The Ohio State University, 453 W 10th Avenue, Columbus, OH, USA. laura.schmitt@osumc.edu. 11. Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA. laura.schmitt@osumc.edu. 12. Division of Physical Therapy, The Ohio State University, 453 W 10th Avenue, 516 Atwell Hall, Columbus, OH, USA. laura.schmitt@osumc.edu.
Abstract
PURPOSE: The purpose was to test the following hypotheses: (1) magnetic resonance imaging (MRI) markers of early knee cartilage degeneration would be present in the involved limb of young athletes after anterior cruciate ligament reconstruction (ACLR) and (2) poor knee function would be associated with MRI markers of cartilage degeneration. METHODS: Twenty-five young athletes after primary, unilateral ACLR (mean age, 16.7 years) were followed to 5-year post-return-to-sport (RTS) clearance, as a part of a larger, prospective cohort study in young athletes post-ACLR. At 2-year post-RTS, patient-reported knee function was evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS). At 5-year post-RTS, qualitative MRI sequences (3 T) and quantitative T1rho and T2 maps segmented into six regions at the femur and tibia were performed for the involved and uninvolved knee cartilages. Relaxation times were compared between knees using Holm-corrected paired t tests. Linear regression was used to examine the association between KOOS scores at 2 years and relaxation times at 5 years. RESULTS: Elevated T1rho and T2 relaxation times were observed in the involved knee at the anterior medial femoral condyle compared to the uninvolved knee (p = 0.006, p = 0.024, respectively). Lower KOOS-Pain, KOOS-Symptoms, KOOS-ADL, and KOOS-Sport scores at 2-year post-RTS were associated with higher T1rho or T2 relaxation times in various regions of the involved knee at 5-year post-RTS (all p < 0.05). CONCLUSIONS: MRI markers of early cartilage degeneration were identified in the medial compartment of the involved knee in young athletes 5-year post-RTS after ACLR. Lower KOOS scores at 2-year post-RTS were associated with elevated knee cartilage T1rho and T2 relaxation times at 5-year post-RTS. Evaluating patient-reported function over time after ACLR appears to provide insight into future degenerative changes in the knee cartilage matrix.
PURPOSE: The purpose was to test the following hypotheses: (1) magnetic resonance imaging (MRI) markers of early knee cartilage degeneration would be present in the involved limb of young athletes after anterior cruciate ligament reconstruction (ACLR) and (2) poor knee function would be associated with MRI markers of cartilage degeneration. METHODS: Twenty-five young athletes after primary, unilateral ACLR (mean age, 16.7 years) were followed to 5-year post-return-to-sport (RTS) clearance, as a part of a larger, prospective cohort study in young athletes post-ACLR. At 2-year post-RTS, patient-reported knee function was evaluated using the Knee injury and Osteoarthritis Outcome Score (KOOS). At 5-year post-RTS, qualitative MRI sequences (3 T) and quantitative T1rho and T2 maps segmented into six regions at the femur and tibia were performed for the involved and uninvolved knee cartilages. Relaxation times were compared between knees using Holm-corrected paired t tests. Linear regression was used to examine the association between KOOS scores at 2 years and relaxation times at 5 years. RESULTS: Elevated T1rho and T2 relaxation times were observed in the involved knee at the anterior medial femoral condyle compared to the uninvolved knee (p = 0.006, p = 0.024, respectively). Lower KOOS-Pain, KOOS-Symptoms, KOOS-ADL, and KOOS-Sport scores at 2-year post-RTS were associated with higher T1rho or T2 relaxation times in various regions of the involved knee at 5-year post-RTS (all p < 0.05). CONCLUSIONS: MRI markers of early cartilage degeneration were identified in the medial compartment of the involved knee in young athletes 5-year post-RTS after ACLR. Lower KOOS scores at 2-year post-RTS were associated with elevated knee cartilage T1rho and T2 relaxation times at 5-year post-RTS. Evaluating patient-reported function over time after ACLR appears to provide insight into future degenerative changes in the knee cartilage matrix.
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