Structural Consequences of a Partial Anterior Cruciate Ligament Injury on Remaining Joint Integrity: Evidence for Ligament and Bone Changes Over Time in an Ovine Model

2021 ◽  
Vol 49 (3) ◽  
pp. 637-648
Author(s):  
Kristen I. Barton ◽  
Bryan J. Heard ◽  
Andres Kroker ◽  
Johnathan L. Sevick ◽  
Duncan A. Raymond ◽  
...  
Keyword(s):  
Subchondral Bone ◽  
Knee Injury ◽  
Bone Microarchitecture ◽  
Cruciate Ligament ◽  
Mineral Density ◽  
Trabecular Bone Mineral Density ◽  
Bone Changes ◽  
Articular Ligaments ◽  
Anterior Cruciate ◽  
Acl Transection

Background: Severe injury to the knee joint often results in accelerated posttraumatic osteoarthritis (PTOA). In an ovine knee injury model, altered kinematics and degradation of the cartilage have been observed at 20 and 40 weeks after partial anterior cruciate ligament (ACL) transection (p-ACL Tx) surgery. However, changes to the integrity of the remaining intact intra-articular ligaments (posterolateral [PL] band and posterior cruciate ligament [PCL]) as well as the subchondral bone after anteromedial (AM) band Tx remain to be characterized. Purpose: (1) To investigate histological alterations to the remaining intact intra-articular ligaments, the synovium, and the infrapatellar fat pad (IPFP) and (2) to quantify subchondral bone changes at the contact surfaces of the proximal tibia at 20 and 40 weeks after AM band Tx. Study Design: Descriptive laboratory study. Methods: Mature female Suffolk cross sheep were allocated into 3 groups: nonoperative controls (n = 6), 20 weeks after partial ACL transection (p-ACL Tx; n = 5), and 40 weeks after p-ACL Tx (n = 6). Ligament, synovium, and IPFP sections were stained and graded. Tibial subchondral bone microarchitecture was assessed using high-resolution peripheral quantitative computed tomography. Results: p-ACL Tx of the AM band led to significant change in histological scores of the PL band and the PCL at 20 weeks after p-ACL Tx ( P = .031 and P = .033, respectively) and 40 weeks after p-ACL Tx ( P = .011 and P = .029) as compared with nonoperative controls. Alterations in inflammatory cells and collagen fiber orientation contributed to the greatest extent of the combined histological score in the PL band and PCL. p-ACL Tx did not lead to chronic activation of the synovium or IPFP. Trabecular bone mineral density was strongly inversely correlated with combined gross morphological damage in the top and middle layers of the subchondral bone in the lateral tibial plateau for animals at 40 weeks after p-ACL Tx. Conclusion: p-ACL Tx influences the integrity (biology and structure) of remaining intact intra-articular ligaments and bone microarchitecture in a partial knee injury ovine model. Clinical Relevance: p-ACL Tx leads to alterations in structural integrity of the remaining intact ligaments and degenerative changes in the trabecular bone mineral density, which may be detrimental to the injured athlete’s knee joint in the long term.

Early Alterations of Subchondral Bone in the Rat Anterior Cruciate Ligament Transection Model of Osteoarthritis

Cartilage ◽  
2019 ◽  
pp. 194760351987847 ◽  
Author(s):  
Nik Aizah ◽  
Pan Pan Chong ◽  
Tunku Kamarul
Keyword(s):  
Anterior Cruciate Ligament ◽  
Articular Cartilage ◽  
Subchondral Bone ◽  
Cruciate Ligament ◽  
Quantitative Computed Tomography ◽  
Cartilage Loss ◽  
Control Group ◽  
Mineral Density ◽  
Anterior Cruciate Ligament Transection ◽  
Anterior Cruciate

Objective Advances in research have shown that the subchondral bone plays an important role in the propagation of cartilage loss and progression of osteoarthritis (OA), but whether the subchondral bone changes precede or lead to articular cartilage loss remains debatable. In order to elucidate the subchondral bone and cartilage changes that occur in early OA, an experiment using anterior cruciate ligament transection (ACLT) induced posttraumatic OA model of the rat knee was conducted. Design Forty-two Sprague Dawley rats were divided into 2 groups: the ACLT group and the nonoperated control group. Surgery was conducted on the ACLT group, and subsequently rats from both groups were sacrificed at 1, 2, and 3 weeks postsurgery. Subchondral bone was evaluated using a high-resolution peripheral quantitative computed tomography scanner, while cartilage was histologically evaluated and scored. Results A significant reduction in the subchondral trabecular bone thickness and spacing was found as early as 1 week postsurgery in ACLT rats compared with the nonoperated control. This was subsequently followed by a reduction in bone mineral density and bone fractional volume at week 2, and finally a decrease in the trabecular number at week 3. These changes occurred together with cartilage degeneration as reflected by an increasing Mankin score over all 3 weeks. Conclusions Significant changes in subchondral bone occur very early in OA concurrent with surface articular cartilage degenerative change suggest that factors affecting bone remodeling and resorption together with cartilage matrix degradation occur very early in the disease.

Periarticular cancellous bone changes following anterior cruciate ligament injury

2001 ◽  
Vol 91 (1) ◽  
pp. 336-342 ◽  
Author(s):  
Gregory R. Wohl ◽  
Roxane C. Shymkiw ◽  
John R. Matyas ◽  
Reinhard Kloiber ◽  
Ronald F. Zernicke
Keyword(s):  
Mechanical Properties ◽  
Bone Mineral Density ◽  
Anterior Cruciate Ligament ◽  
Articular Cartilage ◽  
Bone Mineral ◽  
Cancellous Bone ◽  
Cruciate Ligament ◽  
Mineral Density ◽  
Bone Changes ◽  
Anterior Cruciate

To understand more fully the early bone changes in an experimental model of osteoarthrosis, we quantified periarticular bone mineral density and bone mechanical properties in anterior cruciate ligament transected (ACLX) knee joints (4, 10, 32, and 39 wk post-ACLX) compared with contralateral joints and unoperated normal joints of skeletally mature animals. Maximal stress and energy were significantly reduced in ACLX cancellous bone from the medial femoral condyles at 4 wk postinjury. All mechanical properties (e.g., yield stress and elastic modulus) declined after 4 wk and were significantly reduced at 10 wk. ACLX bone mineral density was significantly reduced at all measured time points. Ash content was significantly reduced at 10 and 32 wk. Changes in the lateral condyles were similar but less pronounced than in the medial condyles. These bony changes accompanied the earliest articular cartilage molecular changes and preceded changes in the articular cartilage gross morphology. We suggest that these early changes in bone mechanical behavior contribute to the progression of osteoarthrosis and pathogenic changes in the joint.

scholarly journals Effects of Nrf2 Deficiency on Bone Microarchitecture in an Experimental Model of Osteoporosis

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Lidia Ibáñez ◽  
María Luisa Ferrándiz ◽  
Rita Brines ◽  
David Guede ◽  
Antonio Cuadrado ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Bone Marrow ◽  
Bone Metabolism ◽  
Bone Microarchitecture ◽  
Related Factor ◽  
Mineral Density ◽  
Trabecular Bone Mineral Density ◽  
Bone Marrow Derived Cells

Objective. Redox imbalance contributes to bone fragility. We have evaluated the in vivo role of nuclear factor erythroid derived 2-related factor-2 (Nrf2), an important regulator of cellular responses to oxidative stress, in bone metabolism using a model of postmenopausal osteoporosis.Methods. Ovariectomy was performed in both wild-type and mice deficient in Nrf2 (Nrf2−/−). Bone microarchitecture was analyzed byμCT. Serum markers of bone metabolism were also measured. Reactive oxygen species production was determined using dihydrorhodamine 123.Results. Sham-operated or ovariectomized Nrf2−/−mice exhibit a loss in trabecular bone mineral density in femur, accompanied by a reduction in cortical area in vertebrae. Nrf2 deficiency tended to increase osteoblastic markers and significantly enhanced osteoclastic markers in sham-operated animals indicating an increased bone turnover with a main effect on bone resorption. We have also shown an increased production of oxidative stress in bone marrow-derived cells from sham-operated or ovariectomized Nrf2−/−mice and a higher responsiveness of bone marrow-derived cells to osteoclastogenic stimuli in vitro.Conclusion. We have demonstrated in vivo a key role of Nrf2 in the maintenance of bone microarchitecture.

scholarly journals Whether Sutures Reduce the Graft Laceration Caused by Interference Screw in Anterior Cruciate Ligament Reconstruction a Biomechanical Study in Vitro

2021 ◽  
Author(s):  
Yuanjun Teng ◽  
Lijun Da ◽  
Xiaohui Zhang ◽  
Hong Wang ◽  
Hua Han ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Interference Screw ◽  
Biomechanical Study ◽  
Protective Effects ◽  
Mineral Density ◽  
Interference Screws ◽  
Anterior Cruciate

Abstract Background: Interference screw is commonly used for graft fixation in anterior cruciate ligament (ACL) reconstruction However, previous studies h a d reported that the insertion of interference screws significantly caused graft laceration . The purpose of this study was to determine whether sutures reduce d the graft laceration from the insertion of interference screws in ACL reconstruction. Methods: Porcine tibias and bovine extensor tendons were used for establishing a knee model of ACL reconstruction in vitro . The ends of grafts were sutured using three different sutures, including the bioabsorbable, Ethibond and ultra high molecular weight polyethylene (UHMWPE) sutures Poly ether ether ketone (PEEK) interference screw s w ere used fortibial fixation Biomechanical tests were performed to investigate the protective effects of different sutures on grafts Results : All prepared tendons and bone specimens showed similar characteristics (length, weight, and pre tension of the tendons, tibial bone mineral density) among all groups ( P 0.05). The biomechanical test s demonstrated that PEEK interference screw s significantly caused the graft laceration P 0.05). However, all sutures (the bioabsorbable, Ethibond and UHMWPE sutures) did not reduce the graft laceration in ACL reconstruction P 0.05). Conclusions : PEEK interference screw s significantly weakened the biomechanical properties of grafts during tibial fixation in ACL reconstruction. Absorbable Ethibond and UHMWPE sutures did not provide protective effects on grafts during ACL reconstruction.

scholarly journals Quadriceps Activation Following Knee Injuries: A Systematic Review

2010 ◽  
Vol 45 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Joseph M. Hart ◽  
Brian Pietrosimone ◽  
Jay Hertel ◽  
Christopher D. Ingersoll
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Injury ◽  
Data Extraction ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Quadriceps Muscle ◽  
Control Group ◽  
Data Sets ◽  
Weighted Mean ◽  
Anterior Cruciate

Abstract Context: Arthrogenic muscle inhibition is an important underlying factor in persistent quadriceps muscle weakness after knee injury or surgery. Objective: To determine the magnitude and prevalence of volitional quadriceps activation deficits after knee injury. Data Sources: Web of Science database. Study Selection: Eligible studies involved human participants and measured quadriceps activation using either twitch interpolation or burst superimposition on patients with knee injuries or surgeries such as anterior cruciate ligament deficiency (ACLd), anterior cruciate ligament reconstruction (ACLr), and anterior knee pain (AKP). Data Extraction: Means, measures of variability, and prevalence of quadriceps activation (QA) failure (<95%) were recorded for experiments involving ACLd (10), ACLr (5), and AKP (3). Data Synthesis: A total of 21 data sets from 18 studies were initially identified. Data from 3 studies (1 paper reporting data for both ACLd and ACLr, 1 on AKP, and the postarthroscopy paper) were excluded from the primary analyses because only graphical data were reported. Of the remaining 17 data sets (from 15 studies), weighted mean QA in 352 ACLd patients was 87.3% on the involved side, 89.1% on the uninvolved side, and 91% in control participants. The QA failure prevalence ranged from 0% to 100%. Weighted mean QA in 99 total ACLr patients was 89.2% on the involved side, 84% on the uninvolved side, and 98.5% for the control group, with prevalence ranging from 0% to 71%. Thirty-eight patients with AKP averaged 78.6% on the involved side and 77.7% on the contralateral side. Bilateral QA failure was commonly reported in patients. Conclusions: Quadriceps activation failure is common in patients with ACLd, ACLr, and AKP and is often observed bilaterally.

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