Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction
Purpose Quadriceps weakness following anterior cruciate ligament reconstruction (ACLR) is linked to decreased patient-reported function, altered lower extremity biomechanics and tibiofemoral joint space narrowing. It remains unknown if quadriceps weakness is associated with early deleterious changes...
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| Veröffentlicht in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2019-08, Vol.27 (8), p.2632-2642 |
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| creator | Pietrosimone, Brian Pfeiffer, Steven J. Harkey, Matthew S. Wallace, Kyle Hunt, Christian Blackburn, J. Troy Schmitz, Randy Lalush, David Nissman, Daniel Spang, Jeffrey T. |
| description | Purpose
Quadriceps weakness following anterior cruciate ligament reconstruction (ACLR) is linked to decreased patient-reported function, altered lower extremity biomechanics and tibiofemoral joint space narrowing. It remains unknown if quadriceps weakness is associated with early deleterious changes to femoral cartilage composition that are suggestive of posttraumatic osteoarthritis development. The purpose of the cross-sectional study was to determine if quadriceps strength was associated with T1ρ relaxation times, a marker of proteoglycan density, of the articular cartilage in the medial and lateral femoral condyles 6 months following ACLR. It is hypothesized that individuals with weaker quadriceps would demonstrate lesser proteoglycan density.
Methods
Twenty-seven individuals (15 females, 12 males) with a patellar tendon autograft ACLR underwent isometric quadriceps strength assessments in 90°of knee flexion during a 6-month follow-up exam. Magnetic resonance images (MRI) were collected bilaterally and voxel by voxel T1ρ relaxation times were calculated using a five-image sequence and a monoexponential equation. Following image registration, the articular cartilage for the weight-bearing surfaces of the medial and lateral femoral condyles (MFC and LFC) were manually segmented and further sub-sectioned into posterior, central and anterior regions of interest (ROI) based on the corresponding meniscal anatomy viewed in the sagittal plane. Univariate linear regression models were used to determine the association between quadriceps strength and T1ρ relaxation times in the entire weight-bearing MFC and LFC, as well as the ROI in each respective limb.
Results
Lesser quadriceps strength was significantly associated with greater T1ρ relaxation times in the entire weight-bearing MFC (
R
2
= 0.14,
P
= 0.05) and the anterior-MFC ROI (
R
2
= 0.22,
P
= 0.02) of the ACLR limb. A post hoc analysis found lesser strength and greater T1ρ relaxation times were significantly associated in a subsection of participants (
n
= 18) without a concomitant medial tibiofemoral compartment meniscal or chondral injury in the entire weight-bearing MFC, as well as anterior-MFC and central-MFC ROI of the ACLR and uninjured limb.
Conclusions
The association between weaker quadriceps and greater T1ρ relaxation times in the MFC suggests deficits in lower extremity muscle strength may be related to cartilage composition as early as 6 months following ACLR. Maximizing quadriceps strengt |
| doi_str_mv | 10.1007/s00167-018-5290-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2158240757</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2158240757</sourcerecordid><originalsourceid>FETCH-LOGICAL-c287y-960762a295f2a3a573f1ed6bfd8289e50ca9c8bdddd73b3c34fb5fc21f0073c83</originalsourceid><addsrcrecordid>eNp1Uctu1DAUtRAVHQY-gA2yxIZNqB9JnCxRxUuqhCqVdeQ41xkXxx7sRO0s-ROWfAc_wC9xw5QiIeHNub4-9xzrHkKecfaKM6bOMmO8VgXjTVGJlhWHB2TDSykLJUv1kGxYW4pCsKo-JY9zvmYMy7J9RE4lFqws6w35frnoITkD-0xvQH8OkDPVOUfj9AzYc_OOjgnwkugV__mVJvD6Vs8uBjq7CahD3AGdYHDaUwtTTIg6zc4sXidq1tLrEWj949sUw7zL1Ebv440LI9UBhV1EWlp-W1LvRj1BmNHIxJBn7K9mT8iJ1T7D0zvckk9v31ydvy8uPr77cP76ojCiUYeirZmqhRZtZYWWulLSchjq3g6NaFqomNGtafoBj5K9NLK0fWWN4BYXKk0jt-TlUXef4pcF8txNLhvwXgeIS-4ErxpRMoXKW_LiH-p1XFLA360spRgrFUcWP7JMijknsN0-uUmnQ8dZt8bYHWPsMMZujbE74MzzO-Wlx8XeT_zJDQniSMj4FEZIf63_r_oLS4OukA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2157700471</pqid></control><display><type>article</type><title>Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>SpringerLink Journals - AutoHoldings</source><creator>Pietrosimone, Brian ; Pfeiffer, Steven J. ; Harkey, Matthew S. ; Wallace, Kyle ; Hunt, Christian ; Blackburn, J. Troy ; Schmitz, Randy ; Lalush, David ; Nissman, Daniel ; Spang, Jeffrey T.</creator><creatorcontrib>Pietrosimone, Brian ; Pfeiffer, Steven J. ; Harkey, Matthew S. ; Wallace, Kyle ; Hunt, Christian ; Blackburn, J. Troy ; Schmitz, Randy ; Lalush, David ; Nissman, Daniel ; Spang, Jeffrey T.</creatorcontrib><description>Purpose
Quadriceps weakness following anterior cruciate ligament reconstruction (ACLR) is linked to decreased patient-reported function, altered lower extremity biomechanics and tibiofemoral joint space narrowing. It remains unknown if quadriceps weakness is associated with early deleterious changes to femoral cartilage composition that are suggestive of posttraumatic osteoarthritis development. The purpose of the cross-sectional study was to determine if quadriceps strength was associated with T1ρ relaxation times, a marker of proteoglycan density, of the articular cartilage in the medial and lateral femoral condyles 6 months following ACLR. It is hypothesized that individuals with weaker quadriceps would demonstrate lesser proteoglycan density.
Methods
Twenty-seven individuals (15 females, 12 males) with a patellar tendon autograft ACLR underwent isometric quadriceps strength assessments in 90°of knee flexion during a 6-month follow-up exam. Magnetic resonance images (MRI) were collected bilaterally and voxel by voxel T1ρ relaxation times were calculated using a five-image sequence and a monoexponential equation. Following image registration, the articular cartilage for the weight-bearing surfaces of the medial and lateral femoral condyles (MFC and LFC) were manually segmented and further sub-sectioned into posterior, central and anterior regions of interest (ROI) based on the corresponding meniscal anatomy viewed in the sagittal plane. Univariate linear regression models were used to determine the association between quadriceps strength and T1ρ relaxation times in the entire weight-bearing MFC and LFC, as well as the ROI in each respective limb.
Results
Lesser quadriceps strength was significantly associated with greater T1ρ relaxation times in the entire weight-bearing MFC (
R
2
= 0.14,
P
= 0.05) and the anterior-MFC ROI (
R
2
= 0.22,
P
= 0.02) of the ACLR limb. A post hoc analysis found lesser strength and greater T1ρ relaxation times were significantly associated in a subsection of participants (
n
= 18) without a concomitant medial tibiofemoral compartment meniscal or chondral injury in the entire weight-bearing MFC, as well as anterior-MFC and central-MFC ROI of the ACLR and uninjured limb.
Conclusions
The association between weaker quadriceps and greater T1ρ relaxation times in the MFC suggests deficits in lower extremity muscle strength may be related to cartilage composition as early as 6 months following ACLR. Maximizing quadriceps strength in the first 6 months following ACLR may be critical for promoting cartilage health early following ACLR.
Level of evidence
Prognostic level 1.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-018-5290-y</identifier><identifier>PMID: 30560446</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Anterior cruciate ligament ; Anterior Cruciate Ligament Injuries - surgery ; Anterior Cruciate Ligament Reconstruction ; Bearing ; Biocompatibility ; Biomechanics ; Biomedical materials ; Cartilage ; Cartilage (articular) ; Cartilage diseases ; Cartilage, Articular - chemistry ; Cartilage, Articular - diagnostic imaging ; Composition ; Cross-Sectional Studies ; Density ; Female ; Females ; Femur ; Femur - surgery ; Humans ; Image registration ; Isometric Contraction ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - surgery ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Males ; Medicine ; Medicine & Public Health ; Meniscus ; Muscle contraction ; Muscle Strength ; Orthopedics ; Osteoarthritis ; Patellar Ligament - transplantation ; Proteoglycans ; Proteoglycans - analysis ; Quadriceps muscle ; Quadriceps Muscle - physiology ; Regression analysis ; Regression models ; Relaxation time ; Transplantation, Autologous ; Weight ; Young Adult</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019-08, Vol.27 (8), p.2632-2642</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018</rights><rights>Knee Surgery, Sports Traumatology, Arthroscopy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c287y-960762a295f2a3a573f1ed6bfd8289e50ca9c8bdddd73b3c34fb5fc21f0073c83</citedby><cites>FETCH-LOGICAL-c287y-960762a295f2a3a573f1ed6bfd8289e50ca9c8bdddd73b3c34fb5fc21f0073c83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-018-5290-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-018-5290-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30560446$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pietrosimone, Brian</creatorcontrib><creatorcontrib>Pfeiffer, Steven J.</creatorcontrib><creatorcontrib>Harkey, Matthew S.</creatorcontrib><creatorcontrib>Wallace, Kyle</creatorcontrib><creatorcontrib>Hunt, Christian</creatorcontrib><creatorcontrib>Blackburn, J. Troy</creatorcontrib><creatorcontrib>Schmitz, Randy</creatorcontrib><creatorcontrib>Lalush, David</creatorcontrib><creatorcontrib>Nissman, Daniel</creatorcontrib><creatorcontrib>Spang, Jeffrey T.</creatorcontrib><title>Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
Quadriceps weakness following anterior cruciate ligament reconstruction (ACLR) is linked to decreased patient-reported function, altered lower extremity biomechanics and tibiofemoral joint space narrowing. It remains unknown if quadriceps weakness is associated with early deleterious changes to femoral cartilage composition that are suggestive of posttraumatic osteoarthritis development. The purpose of the cross-sectional study was to determine if quadriceps strength was associated with T1ρ relaxation times, a marker of proteoglycan density, of the articular cartilage in the medial and lateral femoral condyles 6 months following ACLR. It is hypothesized that individuals with weaker quadriceps would demonstrate lesser proteoglycan density.
Methods
Twenty-seven individuals (15 females, 12 males) with a patellar tendon autograft ACLR underwent isometric quadriceps strength assessments in 90°of knee flexion during a 6-month follow-up exam. Magnetic resonance images (MRI) were collected bilaterally and voxel by voxel T1ρ relaxation times were calculated using a five-image sequence and a monoexponential equation. Following image registration, the articular cartilage for the weight-bearing surfaces of the medial and lateral femoral condyles (MFC and LFC) were manually segmented and further sub-sectioned into posterior, central and anterior regions of interest (ROI) based on the corresponding meniscal anatomy viewed in the sagittal plane. Univariate linear regression models were used to determine the association between quadriceps strength and T1ρ relaxation times in the entire weight-bearing MFC and LFC, as well as the ROI in each respective limb.
Results
Lesser quadriceps strength was significantly associated with greater T1ρ relaxation times in the entire weight-bearing MFC (
R
2
= 0.14,
P
= 0.05) and the anterior-MFC ROI (
R
2
= 0.22,
P
= 0.02) of the ACLR limb. A post hoc analysis found lesser strength and greater T1ρ relaxation times were significantly associated in a subsection of participants (
n
= 18) without a concomitant medial tibiofemoral compartment meniscal or chondral injury in the entire weight-bearing MFC, as well as anterior-MFC and central-MFC ROI of the ACLR and uninjured limb.
Conclusions
The association between weaker quadriceps and greater T1ρ relaxation times in the MFC suggests deficits in lower extremity muscle strength may be related to cartilage composition as early as 6 months following ACLR. Maximizing quadriceps strength in the first 6 months following ACLR may be critical for promoting cartilage health early following ACLR.
Level of evidence
Prognostic level 1.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anterior cruciate ligament</subject><subject>Anterior Cruciate Ligament Injuries - surgery</subject><subject>Anterior Cruciate Ligament Reconstruction</subject><subject>Bearing</subject><subject>Biocompatibility</subject><subject>Biomechanics</subject><subject>Biomedical materials</subject><subject>Cartilage</subject><subject>Cartilage (articular)</subject><subject>Cartilage diseases</subject><subject>Cartilage, Articular - chemistry</subject><subject>Cartilage, Articular - diagnostic imaging</subject><subject>Composition</subject><subject>Cross-Sectional Studies</subject><subject>Density</subject><subject>Female</subject><subject>Females</subject><subject>Femur</subject><subject>Femur - surgery</subject><subject>Humans</subject><subject>Image registration</subject><subject>Isometric Contraction</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - surgery</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Males</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meniscus</subject><subject>Muscle contraction</subject><subject>Muscle Strength</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Patellar Ligament - transplantation</subject><subject>Proteoglycans</subject><subject>Proteoglycans - analysis</subject><subject>Quadriceps muscle</subject><subject>Quadriceps Muscle - physiology</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Relaxation time</subject><subject>Transplantation, Autologous</subject><subject>Weight</subject><subject>Young Adult</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1Uctu1DAUtRAVHQY-gA2yxIZNqB9JnCxRxUuqhCqVdeQ41xkXxx7sRO0s-ROWfAc_wC9xw5QiIeHNub4-9xzrHkKecfaKM6bOMmO8VgXjTVGJlhWHB2TDSykLJUv1kGxYW4pCsKo-JY9zvmYMy7J9RE4lFqws6w35frnoITkD-0xvQH8OkDPVOUfj9AzYc_OOjgnwkugV__mVJvD6Vs8uBjq7CahD3AGdYHDaUwtTTIg6zc4sXidq1tLrEWj949sUw7zL1Ebv440LI9UBhV1EWlp-W1LvRj1BmNHIxJBn7K9mT8iJ1T7D0zvckk9v31ydvy8uPr77cP76ojCiUYeirZmqhRZtZYWWulLSchjq3g6NaFqomNGtafoBj5K9NLK0fWWN4BYXKk0jt-TlUXef4pcF8txNLhvwXgeIS-4ErxpRMoXKW_LiH-p1XFLA360spRgrFUcWP7JMijknsN0-uUmnQ8dZt8bYHWPsMMZujbE74MzzO-Wlx8XeT_zJDQniSMj4FEZIf63_r_oLS4OukA</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Pietrosimone, Brian</creator><creator>Pfeiffer, Steven J.</creator><creator>Harkey, Matthew S.</creator><creator>Wallace, Kyle</creator><creator>Hunt, Christian</creator><creator>Blackburn, J. Troy</creator><creator>Schmitz, Randy</creator><creator>Lalush, David</creator><creator>Nissman, Daniel</creator><creator>Spang, Jeffrey T.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20190801</creationdate><title>Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction</title><author>Pietrosimone, Brian ; Pfeiffer, Steven J. ; Harkey, Matthew S. ; Wallace, Kyle ; Hunt, Christian ; Blackburn, J. Troy ; Schmitz, Randy ; Lalush, David ; Nissman, Daniel ; Spang, Jeffrey T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c287y-960762a295f2a3a573f1ed6bfd8289e50ca9c8bdddd73b3c34fb5fc21f0073c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anterior cruciate ligament</topic><topic>Anterior Cruciate Ligament Injuries - surgery</topic><topic>Anterior Cruciate Ligament Reconstruction</topic><topic>Bearing</topic><topic>Biocompatibility</topic><topic>Biomechanics</topic><topic>Biomedical materials</topic><topic>Cartilage</topic><topic>Cartilage (articular)</topic><topic>Cartilage diseases</topic><topic>Cartilage, Articular - chemistry</topic><topic>Cartilage, Articular - diagnostic imaging</topic><topic>Composition</topic><topic>Cross-Sectional Studies</topic><topic>Density</topic><topic>Female</topic><topic>Females</topic><topic>Femur</topic><topic>Femur - surgery</topic><topic>Humans</topic><topic>Image registration</topic><topic>Isometric Contraction</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - surgery</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Males</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meniscus</topic><topic>Muscle contraction</topic><topic>Muscle Strength</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Patellar Ligament - transplantation</topic><topic>Proteoglycans</topic><topic>Proteoglycans - analysis</topic><topic>Quadriceps muscle</topic><topic>Quadriceps Muscle - physiology</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Relaxation time</topic><topic>Transplantation, Autologous</topic><topic>Weight</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pietrosimone, Brian</creatorcontrib><creatorcontrib>Pfeiffer, Steven J.</creatorcontrib><creatorcontrib>Harkey, Matthew S.</creatorcontrib><creatorcontrib>Wallace, Kyle</creatorcontrib><creatorcontrib>Hunt, Christian</creatorcontrib><creatorcontrib>Blackburn, J. Troy</creatorcontrib><creatorcontrib>Schmitz, Randy</creatorcontrib><creatorcontrib>Lalush, David</creatorcontrib><creatorcontrib>Nissman, Daniel</creatorcontrib><creatorcontrib>Spang, Jeffrey T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pietrosimone, Brian</au><au>Pfeiffer, Steven J.</au><au>Harkey, Matthew S.</au><au>Wallace, Kyle</au><au>Hunt, Christian</au><au>Blackburn, J. Troy</au><au>Schmitz, Randy</au><au>Lalush, David</au><au>Nissman, Daniel</au><au>Spang, Jeffrey T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>27</volume><issue>8</issue><spage>2632</spage><epage>2642</epage><pages>2632-2642</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
Quadriceps weakness following anterior cruciate ligament reconstruction (ACLR) is linked to decreased patient-reported function, altered lower extremity biomechanics and tibiofemoral joint space narrowing. It remains unknown if quadriceps weakness is associated with early deleterious changes to femoral cartilage composition that are suggestive of posttraumatic osteoarthritis development. The purpose of the cross-sectional study was to determine if quadriceps strength was associated with T1ρ relaxation times, a marker of proteoglycan density, of the articular cartilage in the medial and lateral femoral condyles 6 months following ACLR. It is hypothesized that individuals with weaker quadriceps would demonstrate lesser proteoglycan density.
Methods
Twenty-seven individuals (15 females, 12 males) with a patellar tendon autograft ACLR underwent isometric quadriceps strength assessments in 90°of knee flexion during a 6-month follow-up exam. Magnetic resonance images (MRI) were collected bilaterally and voxel by voxel T1ρ relaxation times were calculated using a five-image sequence and a monoexponential equation. Following image registration, the articular cartilage for the weight-bearing surfaces of the medial and lateral femoral condyles (MFC and LFC) were manually segmented and further sub-sectioned into posterior, central and anterior regions of interest (ROI) based on the corresponding meniscal anatomy viewed in the sagittal plane. Univariate linear regression models were used to determine the association between quadriceps strength and T1ρ relaxation times in the entire weight-bearing MFC and LFC, as well as the ROI in each respective limb.
Results
Lesser quadriceps strength was significantly associated with greater T1ρ relaxation times in the entire weight-bearing MFC (
R
2
= 0.14,
P
= 0.05) and the anterior-MFC ROI (
R
2
= 0.22,
P
= 0.02) of the ACLR limb. A post hoc analysis found lesser strength and greater T1ρ relaxation times were significantly associated in a subsection of participants (
n
= 18) without a concomitant medial tibiofemoral compartment meniscal or chondral injury in the entire weight-bearing MFC, as well as anterior-MFC and central-MFC ROI of the ACLR and uninjured limb.
Conclusions
The association between weaker quadriceps and greater T1ρ relaxation times in the MFC suggests deficits in lower extremity muscle strength may be related to cartilage composition as early as 6 months following ACLR. Maximizing quadriceps strength in the first 6 months following ACLR may be critical for promoting cartilage health early following ACLR.
Level of evidence
Prognostic level 1.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30560446</pmid><doi>10.1007/s00167-018-5290-y</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019-08, Vol.27 (8), p.2632-2642 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2158240757 |
| source | MEDLINE; Access via Wiley Online Library; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Adult Anterior cruciate ligament Anterior Cruciate Ligament Injuries - surgery Anterior Cruciate Ligament Reconstruction Bearing Biocompatibility Biomechanics Biomedical materials Cartilage Cartilage (articular) Cartilage diseases Cartilage, Articular - chemistry Cartilage, Articular - diagnostic imaging Composition Cross-Sectional Studies Density Female Females Femur Femur - surgery Humans Image registration Isometric Contraction Knee Knee Joint - diagnostic imaging Knee Joint - surgery Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Males Medicine Medicine & Public Health Meniscus Muscle contraction Muscle Strength Orthopedics Osteoarthritis Patellar Ligament - transplantation Proteoglycans Proteoglycans - analysis Quadriceps muscle Quadriceps Muscle - physiology Regression analysis Regression models Relaxation time Transplantation, Autologous Weight Young Adult |
| title | Quadriceps weakness associates with greater T1ρ relaxation time in the medial femoral articular cartilage 6 months following anterior cruciate ligament reconstruction |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-20T06%3A27%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Quadriceps%20weakness%20associates%20with%20greater%20T1%CF%81%20relaxation%20time%20in%20the%20medial%20femoral%20articular%20cartilage%206%C2%A0months%20following%20anterior%20cruciate%20ligament%20reconstruction&rft.jtitle=Knee%20surgery,%20sports%20traumatology,%20arthroscopy%20:%20official%20journal%20of%20the%20ESSKA&rft.au=Pietrosimone,%20Brian&rft.date=2019-08-01&rft.volume=27&rft.issue=8&rft.spage=2632&rft.epage=2642&rft.pages=2632-2642&rft.issn=0942-2056&rft.eissn=1433-7347&rft_id=info:doi/10.1007/s00167-018-5290-y&rft_dat=%3Cproquest_cross%3E2158240757%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2157700471&rft_id=info:pmid/30560446&rfr_iscdi=true |