Knee joint unloading and daily physical activity associate with cartilage T2 relaxation times 1 month after ACL injury

Wellsandt, Elizabeth; Kallman, Tyler; Golightly, Yvonne; Podsiadlo, Daniel; Dudley, Andrew; Vas, Stephanie; Michaud, Kaleb; Tao, Matthew; Sajja, Balasrinivasa; Manzer, Melissa

Affiliations

¹Division of Physical Therapy Education, University of Nebraska Medical Center, Omaha, Nebraska, USA

²Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA

³College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA

⁴Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

⁵Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

⁶Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

⁷Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

⁸Department of Genetics Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA

⁹Department of Clinical Diagnostic and Therapeutic Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA

¹⁰Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA

¹¹Forward, The National Databank for Rheumatic Diseases, Wichita, Kansas, USA

¹²Department of Radiology, University of Nebraska Medical Center, Omaha, Nebraska, USA

Abstract and keywords

Osteoarthritis (OA) is prevalent after anterior cruciate ligament (ACL) injury, but mechanismsunderlying its development are poorly understood. The purpose of this study was to determine if gait biomechanics and daily physical activity (PA) associate with cartilage T2 relaxation times, a marker of collagen organization and water content, 1 month after ACL injury. Twenty-seven participants (15–35 years old) without chondral lesions completed magnetic resonance imaging, three-dimensional gait analysis, and 1 week of PA accelerometry. Interlimb differences and ratios were calculated for gait biomechanics and T2 relaxation times, respectively. Multiple linear regression models adjusted for age, sex, and concomitant meniscus injury were used to determine the association between gait biomechanics and PA with T2 relaxation times, respectively. Altered knee adduction moment (KAM) impulse, less knee flexion excursion (kEXC) and higher daily step counts accounted for 35.8%–65.8% of T2 relaxation time variation in the weightbearing and posterior cartilage of the medial and lateral compartment (all p ≤ .011). KAM impulse was the strongest factor for T2 relaxation times in all models (all p ≤ .001). Lower KAM impulse associated with longer T2 relaxation times in the injured medial compartment (β = −.720 to −.901) and shorter T2 relaxation in the lateral compartment (β = .713 to .956). At 1 month after ACL injury, altered KAM impulse, less kEXC, and higher PA associated with longer T2 relaxation times, which may indicate poorer cartilage health. Statement of Clinical Significance: Gait biomechanics and daily PA are modifiable targets that may improve cartilage health acutely after ACL injury and slow progression to OA.

Keywords: anterior cruciate ligament; biomechanics; cartilage; gait; osteoarthritis

Links

DOI: 10.1002/jor.25034

PubMed: 33783030

WoS: 000634527000001

History

Received: 2020-11-23

Revised: 2021-02-14

Accepted: 2021-03-10

Cited Works (6)

Year	Entry
1990	Bell AL, Pedersen DR, Brand RA. A comparison of the accuracy of several hip center location prediction methods. J Biomech. 1990;23(6):617-621.
2009	Winter DA. Biomechanics and Motor Control of Human Movement. 4th ed. Hoboken, NJ: Inc, John Wiley & Sons; 2009.
2004	Andriacchi TP, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. March 2004;32(3):447-457.
2006	Yushkevich PA, Piven J, Hazlett HC, Smith RG, Ho S, Gee JC, Gerig G. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. NeuroImage. July 1, 2006;31(3):1116-1128.
1994	Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient: a prospective outcome study. Am J Sports Med. September–October 1994;22(5):632-644.
2014	Sanchez-Adams J, Leddy HA, McNulty AL, O’Conor CJ, Guilak F. The mechanobiology of articular cartilage: bearing the burden of osteoarthritis. Curr Rheumatol Rep. October 2014;16(10):451.

Cited By (2)

Year	Entry
2023	Sullivan B, Stone AV, Conley CEW, Hunt ER, Lattermann C, Jacobs CA. Human synovial fluid interleukin-6, but not type II collagen breakdown, positively correlated with pain after anterior cruciate ligament injury and reconstruction. J Orthop Res. February 2023;41(2):300-306.
2023	Schache AG, Sritharan P, Culvenor AG, Patterson BE, Perraton LG, Bryant AL, Guermazi A, Morris HG, Whitehead TS, Crossley KM. Patellofemoral joint loading and early osteoarthritis after ACL reconstruction. J Orthop Res. July 2023;41(7):1419-1429.