Non-anatomic ACL graft placement linked to reduced cartilage thickness
The results of a new study may impact how ACL reconstruction is performed in the future. Data from the study show that "graft placement may have important implications on the development of osteoarthritis after ACL reconstruction," Eziamaka C. Okafor, MD, and colleagues, concluded in the study, which highlighted the importance of anatomic ACL reconstruction.
Investigators used high-resolution MRI to study 22 patients who underwent ACL reconstruction with either anatomic graft placement (10 patients) or non-anatomic graft placement (12 patients). At 18 to 20 months mean after ACL surgery, each patient had a 3D mesh model made of their knees and Okafor and colleagues used those to make site-specific comparisons between the patients’ healthy and ACL-repaired knees. The researchers also evaluated the femoral, tibial and articular cartilage thickness.Based on the results, patients in the group with non-anatomic graft placement (which can cause abnormal joint motion) experienced an 8% decrease in cartilage thickness along the medial intercondylar notch in the repaired knee vs. the intact contralateral knee. However, investigators reported no significant changes in cartilage thickness for the ACL-repaired knee vs. the intact knee in the anatomic graft placement group. Therefore, they determined the normal motion of the joint was unchanged.
"These findings suggest that restoring normal knee motion after ACL injury may help to slow the progression of degeneration," Okafor and colleagues wrote. "Abnormal knee motion is believed to be an important factor contributing to the development of OA [osteoarthritis] after ACL reconstruction." – by Christian Ingram
Disclosures: The authors acknowledge the support of research grants from Arthrex, the National Football Charities, and the NIH (AR063325 and AR055659).