3D bone-shape changes and their correlations with cartilage T1ρ and T2 relaxation times and patient-reported outcomes over 3-years after ACL reconstruction

Q Zhong; V Pedoia; M Tanaka; J Neumann; T M Link; B Ma; J Lin; X Li

doi:10.1016/j.joca.2019.01.017

3D bone-shape changes and their correlations with cartilage T1ρ and T2 relaxation times and patient-reported outcomes over 3-years after ACL reconstruction

Osteoarthritis Cartilage. 2019 Jun;27(6):915-921. doi: 10.1016/j.joca.2019.01.017. Epub 2019 Feb 23.

Authors

Q Zhong¹, V Pedoia², M Tanaka³, J Neumann⁴, T M Link⁵, B Ma⁶, J Lin⁷, X Li⁸

Affiliations

¹ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; Arthritis Clinic and Research Center, Peking University People's Hospital, Beijing, China. Electronic address: [email protected].
² Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
³ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
⁴ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
⁵ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
⁶ Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, CA, USA. Electronic address: [email protected].
⁷ Arthritis Clinic and Research Center, Peking University People's Hospital, Beijing, China. Electronic address: [email protected].
⁸ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA; Program of Advanced Musculoskeletal Imaging (PAMI), Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA. Electronic address: [email protected].

Abstract

Purpose: (1) To identify bone-shape changes from baseline to 3-years after anterior cruciate ligament reconstruction (ACLR). (2) to assess association between changes in bone-shape from baseline to 6-months and changes in cartilage matrix and patient functions and symptoms from baseline to 3-years after ACLR.

Methods: Bilateral knees of 30 patients with unilateral ACL injuries were scanned at baseline, 6-months, 1-, 2-, and 3-years after ACLR. Bilateral knees of 13 controls were scanned at baseline, 1- and 3-years. Mean T1ρ and T2 values of each cartilage compartment were computed. Bone shape was quantified using statistical shape modeling (SSM) and 3D-MRI. Patient functions and symptoms were evaluated using Knee Injury and Osteoarthritis Outcome Score (KOOS).

Results: Statistically significant changes were observed in Femur 2 (medial femoral condyle [MF] shape), Femur 6 (intercondylar notch width), Tibia 1 (tibia plateau area), and Tibia 7 (medial tibia slope) over 3-years after ACLR. Statistically significant differences were observed between injured and control knees in several modes. Statistically significant correlations were found between changes in bone shape (ΔFemur 6, ΔFemur 8 [trochlea inclination and MF height], ΔTibia 1) from baseline to 6-months and that of cartilage T1ρ and T2 and KOOS from baseline to 3-years after ACLR.

Conclusion: Bone shape remodeling occurs after ACLR, and early bone shape changes (within 6 months) correlated with cartilage matrix and patient outcomes at 3-years after ACLR. Bone shape can be a promising imaging biomarker that stratifies patients at high risk for post-traumatic osteoarthritis (PTOA).

Keywords: Anterior cruciate ligament; Bone shape; Magnetic resonance imaging; Osteoarthritis; Statistical shape modeling.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Anterior Cruciate Ligament Injuries / surgery*
Anterior Cruciate Ligament Reconstruction*
Cartilage, Articular / diagnostic imaging*
Female
Femur / diagnostic imaging*
Humans
Imaging, Three-Dimensional
Knee Joint / diagnostic imaging
Magnetic Resonance Imaging
Male
Osteoarthritis, Knee / epidemiology*
Patella / diagnostic imaging*
Patient Reported Outcome Measures
Principal Component Analysis
Prognosis
Risk Assessment
Tibia / diagnostic imaging*

Grants and funding

P50 AR060752/AR/NIAMS NIH HHS/United States