Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury

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Chaudhari, Ajit M. W.¹; Briant, Paul L.^2,3; Bevill, Scott L.²; Koo, Seungbum²; Andriacchi, Thomas P.^2,3,4

Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury

Med Sci Sports Exer. February 2008;40(2):215-222

©2008 American College of Sports Medicine

Affiliations

¹Department of Orthopaedics, Ohio State University, Columbus, OH

²Department of Mechanical Engineering, Stanford University, Stanford, CA

³Bone and Joint Center, VA Palo Alto Health System, Palo Alto, CA

⁴Department of Orthopaedic Surgery, Stanford University, Stanford, CA
Abstract and keywords

This review examines a mechanism for the initiation of osteoarthritis after anterior cruciate ligament (ACL) injury by considering the relationship between reported ambulatory changes after ACL injury, cartilage adaptation to load, and the association between cartilage loads during walking and regional variations in cartilage structure and biology. Taken together, these observations suggest that cartilage degeneration after ACL injury could be caused by a kinematic gait change that shifts ambulatory loading applied to cartilage. Such a shift may cause regions of cartilage to become newly loaded, be subjected to altered levels of compression and tension, or become unloaded. The metabolic sensitivity of chondrocytes to such changes in their mechanical environment, combined with the low adaptation potential of mature cartilage, could lead to cartilage degeneration and premature osteoarthritis after ACL injury. This proposed mechanism demonstrates the value of using the ACL injury model to understand the relationship between mechanics and biology, as well as helping to explain the importance of restoring normal ambulatory kinematics after ACL injury to avoid premature osteoarthritis.

Keywords: Review; knee; kinematics; cartilage metabolism; biomechanics; cartilage histology
Links

DOI: 10.1249/mss.0b013e31815cbb0e

PubMed: 18202582

WoS: 000252608300005
History

Received: 2007-04

Accepted: 2007-07

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2022	Brunst C, Ithurburn MP, Zbojniewicz AM, Paterno MV, Schmitt LC. Return-to-sport quadriceps strength symmetry impacts 5-year cartilage integrity after anterior cruciate ligament reconstruction: a preliminary analysis. J Orthop Res. January 2022;40(1):285-294.
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