Tibiofemoral contact and alignment in patients with anterior cruciate ligament rupture treated nonoperatively versus reconstruction

2021 ◽  
Vol 103-B (9) ◽  
pp. 1505-1513
Author(s):  
David J. Stockton ◽  
Andrew M. Schmidt ◽  
Andrew Yung ◽  
Jane Desrochers ◽  
Honglin Zhang ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Contact Area ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Acl Rupture ◽  
Healthy Controls ◽  
The Mean ◽  
Anterior Cruciate ◽  
Time Since Injury ◽  
Centroid Location

Aims Anterior cruciate ligament (ACL) rupture commonly leads to post-traumatic osteoarthritis, regardless of surgical reconstruction. This study uses standing MRI to investigate changes in contact area, contact centroid location, and tibiofemoral alignment between ACL-injured knees and healthy controls, to examine the effect of ACL reconstruction on these parameters. Methods An upright, open MRI was used to directly measure tibiofemoral contact area, centroid location, and alignment in 18 individuals with unilateral ACL rupture within the last five years. Eight participants had been treated nonoperatively and ten had ACL reconstruction performed within one year of injury. All participants were high-functioning and had returned to sport or recreational activities. Healthy contralateral knees served as controls. Participants were imaged in a standing posture with knees fully extended. Results Participants’ mean age was 28.4 years (SD 7.3), the mean time since injury was 2.7 years (SD 1.6), and the mean International Knee Documentation Subjective Knee Form score was 84.4 (SD 13.5). ACL injury was associated with a 10% increase (p = 0.001) in contact area, controlling for compartment, sex, posture, age, body mass, and time since injury. ACL injury was associated with a 5.2% more posteriorly translated medial centroid (p = 0.001), equivalent to a 2.6 mm posterior translation on a representative tibia with mean posteroanterior width of 49.4 mm. Relative to the femur, the tibiae of ACL ruptured knees were 2.3 mm more anteriorly translated (p = 0.003) and 2.6° less externally rotated (p = 0.010) than healthy controls. ACL reconstruction was not associated with an improvement in any measure. Conclusion ACL rupture was associated with an increased contact area, posteriorly translated medial centroid, anterior tibial translation, and reduced tibial external rotation in full extension. These changes were present 2.7 years post-injury regardless of ACL reconstruction status. Cite this article: Bone Joint J 2021;103-B(9):1505–1513.

scholarly journals A Tomahawk Shaped Femur is a Risk Factor for Anterior Cruciate Ligament Injury

2018 ◽  
Vol 6 (4_suppl2) ◽  
pp. 2325967118S0001
Author(s):  
Thomas Pfeiffer ◽  
Jeremy Burnham ◽  
Elmar Herbst ◽  
Sven Shafizadeh ◽  
Volker Musahl
Keyword(s):  
Acl Reconstruction ◽  
Roc Analysis ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Control Group ◽  
Acl Injuries ◽  
Injury Group ◽  
Increased Risk ◽  
The Mean ◽  
Anterior Cruciate

Bony morphologic characteristics have been demonstrated to increase the risk of anterior cruciate ligament (ACL) injury. The purpose of the study was to examine distal femoral morphology relative to ACL injury, reconstruction failure, and contralateral ACL injury. It was hypothesized that an increased posterior femoral condylar depth, quantified as the tomahawk ratio, would correlate with increased risk of primary ACL ruptures, ACL reconstruction failures, and contralateral ACL injuries. Consecutive patients undergoing arthroscopic knee surgery at an academic medical center from 2012-2016 with minimum 24-month follow-up were retrospectively reviewed. Subjects were stratified into four groups: a control group consisting of patients with no ACL injuries and three groups of patients with a primary ACL injury, failed ACL reconstruction, or previous ACL injury with subsequent contralateral ACL injury. Using lateral radiographs, the ratio of posterior condylar depth over total condylar distance was defined as the tomahawk ratio. Analysis-of-variance (ANOVA) and post-hoc testing were used to test for differences in the mean tomahawk ratio between study groups (p<0.05). Receiver Operating Characteristic (ROC) analysis was performed to determine the optimal tomahawk ratio cut-off for detecting increased risk for ACL injury 175 patients met inclusion criteria. The mean tomahawk ratios in the control group, primary ACL injury group, failed ACL reconstruction group, and contralateral ACL injury group were 61.1% (± 2.1), 64.2% (± 3.8), 64.4% (± 3.6), and 66.9% (± 4.0), respectively. Patients with a primary ACL injury, failed ACL reconstruction, or contralateral ACL injury had a significantly higher tomahawk ratio compared to the control group (p<0.008). ROC analysis demonstrated a tomahawk ratio of 63% or greater to be associated with an increased risk for ACL injury with a sensitivity of 83% and a specificity of 71%. The data from this study show that an increased posterior femoral condylar depth, or tomahawk ratio, is associated with increased risk of ACL injury, including primary ACL injury, failed ACL reconstruction, and contralateral ACL injury. Readily identifiable risk factors, such as an increased tomahawk ratio, could assist clinicians in identifying at-risk individuals who may experience greater benefit from targeted ACL injury prevention counseling and intervention. The presence of the tomahawk-shaped femur could also be used to guide treatment decisions and identify ACL reconstruction patients who may benefit from additional surgical procedures such as extra articular tenodesis.

Medial Tibial Slope Determined by Plain Radiography Is Not Associated with Primary or Recurrent Anterior Cruciate Ligament Tears

2018 ◽  
Vol 33 (01) ◽  
pp. 022-028 ◽  
Author(s):  
Alvin W. Su ◽  
Ljiljana Bogunovic ◽  
Matthew V. Smith ◽  
Simon Gortz ◽  
Robert H. Brophy ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Anterior Tibial ◽  
The Mean ◽  
Anterior Cruciate ◽  
Tibial Cortex ◽  
Medial Tibial Slope ◽  
Primary Acl Reconstruction

AbstractIncreased tibial slope may be associated with anterior cruciate ligament (ACL) injuries, although potential confounding effects from various patient characteristics and radiographic quantification methods have not been rigorously studied. The association of the slope of the lateral plateau with recurrent ACL injury after primary ACL reconstruction has recently been reported, but the role of medial slope is less well defined. The purpose of this study was to (1) assess medial tibial slope measurement reliability among examiners, (2) compare medial tibial slope values between patients undergoing primary ACL reconstruction, reinjured patients undergoing revision ACL reconstruction, and a control cohort with an intact ACL, (3) analyze if the medial tibial slope is an independent risk factor for noncontact ACL injury, and (4) assess how different anatomical references affect medial tibial slope values. A total of 206 patients were enrolled into one of three groups: (1) ACL-intact controls (CONTROL, n = 83), (2) first-time ACL-injured patients (PRIMARY, n = 77), and (3) patients undergoing revision ACL reconstruction (REVISION, n = 46). Three fellowship-trained sports medicine surgeons performed repeated measurements of plain lateral radiographs. The medial tibial slope was determined by three anatomical references: anterior tibial cortex (anterior tibial slope [ATS]), posterior tibial cortex (posterior tibial slope [PTS]), and the anatomical long axis of the tibia (composite tibial slope [CTS]). Substantial intra- and interobserver reliabilities were established by the intraclass correlation coefficient of 0.73 to 0.89. There was no difference in CTS, ATS, or PTS comparing the CONTROL, PRIMARY, and REVISION groups upon univariate analyses. Multivariable logistic regression model showed that none of the slope values was independently associated with ACL injury. The mean ATS for all 206 subjects was 4 and 8 degrees greater than the mean CTS and PTS, respectively. ATS correlated only moderately to PTS. We concluded that medial tibial slope measured on radiographs is not associated with primary or recurrent ACL injury, and has substantial variation and suboptimal correlation when using different anatomical references despite good inter- and intraobserver reliabilities.

scholarly journals High Risk of New Knee Injuries in Female Soccer Players After Primary Anterior Cruciate Ligament Reconstruction at 5- to 10-Year Follow-up

2021 ◽  
pp. 036354652110444
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Martin Hägglund
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Injury ◽  
Soccer Players ◽  
Healthy Controls ◽  
Anterior Cruciate

Background: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. Purpose: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer players (controls). Study Design: Cohort study; Level of evidence, 2. Methods: Demographic, soccer-specific, and surgical data were recorded at baseline for 317 female soccer players (mean ± SD age, 20.1 ± 2.7 years) 1.6 ± 0.7 years after ACL reconstruction and for 119 matched controls (mean age, 19.5 ± 2.5 years). Data on new knee injuries and soccer-playing status were collected 5 to 10 years after ACL reconstruction via a questionnaire. Results: Among players with ACL reconstruction, 222 (70%) responded at a mean 6.5 ± 1.0 years after primary ACL reconstruction. We compared 3 cohorts: (1) among 163 players with ACL reconstruction who returned to soccer, 68 (42%) sustained 44 reruptures and 29 contralateral ruptures; (2) among 59 players with ACL reconstruction who did not return to soccer, 11 (19%) sustained 9 reruptures and 2 contralateral ruptures; and (3) among 113 knee-healthy controls, 12 (11%) sustained 13 ACL injuries. Players who returned had a >2-fold higher risk of a new ACL injury than players who did not return (risk ratio, 2.24; 95% CI, 1.27-3.93; P = .005) and a 4-fold higher risk than controls (risk ratio, 3.93; 95% CI, 2.23-6.91; P <.001). A new ACL, meniscal, or cartilage injury was the most frequent new knee injury. Among players who returned to soccer, 68% reported a new knee injury, and they had a 2- to 5-times higher risk of any new knee injury and knee surgery than players who did not return and controls. Conclusion: Two-thirds of female soccer players with ACL reconstruction who returned to soccer sustained a new knee injury within 5 to 10 years; 42% had a new ACL injury. Their risk of a new knee injury and knee surgery was 2 to 5 times greater than that for players who did not return and for knee-healthy controls. New injury may have negative consequences for long-term knee health and should be a critical consideration in the decision to return to play.

Posterior Tibial Slope in Patients Undergoing Anterior Cruciate Ligament Reconstruction With Patellar Tendon Autograft: Analysis of Subsequent ACL Graft Tear or Contralateral ACL Tear

2021 ◽  
Vol 49 (3) ◽  
pp. 620-625
Author(s):  
K. Donald Shelbourne ◽  
Rodney W. Benner ◽  
Jonathan A. Jones ◽  
Tinker Gray
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
The Mean ◽  
Anterior Cruciate ◽  
Tendon Autograft

Background: Reports on greater posterior tibial slope (PTS) and its relationship to subsequent anterior cruciate ligament (ACL) injury show conflicting results; it has not been studied much in patients after ACL reconstruction with patellar tendon autograft (PTG). Hypothesis: Patients who suffered a subsequent ACL injury would have a larger PTS than patients who did not suffer a subsequent injury after primary or revision ACL reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Patients received primary (n = 2439) or revision (n = 324) ACL reconstruction with PTG and were followed prospectively to determine the rate of graft tear and contralateral ACL tear. The PTS was measured preoperatively on digital lateral view radiographs. Intersecting lines were drawn along the medial tibial plateau and posterior tibia; the value of the acute angle at the lines’ intersection was then subtracted from 90° to obtain the PTS. This procedure was completed by a clinical assistant with an intrarater reliability of 0.89. Chi-square analysis and t tests were used to determine the differences between rate of tears and measurements between groups. A threshold of PTS ≥10° was used for analysis. Results: The mean follow-up time was 11.6 ± 4.0 years. After primary surgery, the mean PTS in patients with graft tears was 5.4°± 3.1° versus 4.8°± 2.9° for patients without a tear ( P = .041). The mean PTS was 4.9°± 3.4° for patients with contralateral tears (not statistically significantly different than the no-tear group; P = .80). Furthermore, patients with primary reconstruction with PTS ≥10° had a statistically significantly higher rate of graft tear (9.7%) than patients with PTS ≤9° (4.8%) ( P = .003), but not a higher rate of contralateral tear. Among patients undergoing revision surgery, there were no statistically significant differences between the graft tear, contralateral tear, and no-tear groups with relation to PTS ≥10°. Conclusion: After primary ACL reconstruction, patients with PTS >10° had a higher rate of subsequent graft tear but not a higher rate of contralateral tear. With revision surgery, there was no significant association between PTS and the rate of subsequent tear. Therefore, caution should be exercised when considering more radical interventions, such as osteotomy, to prevent retear in patients with high PTS.

scholarly journals Psychological and Social Components of Recovery Following Anterior Cruciate Ligament Reconstruction in Young Athletes: A Narrative Review

2021 ◽  
Vol 18 (17) ◽  
pp. 9267
Author(s):  
Emil Vutescu ◽  
Sebastian Orman ◽  
Edgar Garcia-Lopez ◽  
Justin Lau ◽  
Andrew Gage ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Narrative Review ◽  
Acl Rupture ◽  
Return To Play ◽  
Young Athletes ◽  
Acl Injuries ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) rupture is a common injury in young athletes. To restore knee stability and function, patients often undergo ACL reconstruction (ACLR). Historically, there has been a focus in this population on the epidemiology of ACL injury, the technical aspects of ACL reconstruction, and post-operative functional outcomes. Although increasingly recognized as an important aspect in recovery, there remains limited literature examining the psychological aspects of post-operative rehabilitation and return to play following youth ACL reconstruction. Despite technical surgical successes and well-designed rehabilitation programs, many athletes never reach their preinjury athletic performance level and some may never return to their primary sport. This suggests that other factors may influence recovery, and indeed this has been documented in the adult literature. In addition to restoration of functional strength and stability, psychological and social factors play an important role in the recovery and overall outcome of ACL injuries in the pediatric population. Factors such as psychological readiness to return-to-play (RTP), motivation, mood disturbance, locus of control, recovery expectations, fear of reinjury, and self-esteem are correlated to the RTP potential of the young athlete. A better understanding of these concepts may help to maximize young patients’ outcomes after ACL reconstruction. The purpose of this article is to perform a narrative review of the current literature addressing psychosocial factors associated with recovery after ACL injury and subsequent reconstruction in young athletes. Our goal is to provide a resource for clinicians treating youth ACL injuries to help identify patients with maladaptive psychological responses after injury and encourage a multidisciplinary approach when treating young athletes with an ACL rupture.

Decreased Postural Control in Patients Undergoing Anterior Cruciate Ligament Reconstruction Compared to Healthy Controls

2020 ◽  
Vol 29 (7) ◽  
pp. 920-925 ◽  
Author(s):  
Jonathon R. Staples ◽  
Kevin A. Schafer ◽  
Matthew V. Smith ◽  
John Motley ◽  
Mark Halstead ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Postural Stability ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Time To Failure ◽  
Healthy Controls ◽  
Anterior Cruciate ◽  
Dynamic Postural Stability

Context: Patients with anterior cruciate ligament (ACL) tears are likely to have deficient dynamic postural stability compared with healthy sex- and age-matched controls. Objectives: To test the hypothesis that patients undergoing ACL reconstruction have decreased dynamic postural stability compared with matched healthy controls. Design: Prospective case-control study. Setting: Orthopedic sports medicine and physical therapy clinics. Patients or Other Participants: Patients aged 20 years and younger with an ACL tear scheduled for reconstruction were enrolled prospectively. Controls were recruited from local high schools and colleges via flyers. Interventions: Patients underwent double-stance dynamic postural stability testing prior to surgery, recording time to failure and dynamic motion analysis (DMA) scores. Patients were then matched with healthy controls. Main Outcome Measures: Demographics, time to failure, and DMA scores were compared between groups. Results: A total of 19 females and 12 males with ACL tears were matched with controls. Individuals with ACL tears were more active (Marx activity score: 15.7 [1.0] vs 10.8 [4.9], P < .001); had shorter times until test failure (84.4 [15.8] vs 99.5 [14.5] s, P < .001); and had higher (worse) DMA scores (627 [147] vs 481 [132], P < .001), indicating less dynamic postural stability. Six patients with ACL deficiency (1 male and 5 females) demonstrated lower (better) DMA scores than their controls, and another 7 (4 males and 3 females) were within 20% of controls. Conclusions: Patients undergoing ACL reconstruction had worse global dynamic postural stability compared with well-matched controls. This may represent the effect of the ACL injury or preexisting deficits that contributed to the injury itself. These differences should be studied further to evaluate their relevance to ACL injury risk, rehabilitation, and return to play.

scholarly journals Association of Prior Anterior Cruciate Ligament Tear With Decreased Career Longevity in Women’s National Basketball Association

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110092
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Toufic R. Jildeh ◽  
Mohammad Sattar ◽  
Alexander Ziedas ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
National Basketball Association ◽  
Healthy Controls ◽  
Acl Tear ◽  
History Of ◽  
Anterior Cruciate ◽  
And Performance

Background: The incidence of anterior cruciate ligament (ACL) injuries in women’s basketball exceeds that of men. There is a paucity of data regarding career performance in Women’s National Basketball Association (WNBA) athletes with a history of ACL reconstruction. Purpose: To determine whether WNBA athletes with a history of ACL injury prior to professional play have reduced career game utilization, defined as games played and started and minutes per game (MPG), as well as statistical performance, defined by player efficiency rating (PER). Study Design: Cohort study; Level of evidence, 3. Methods: Included were 42 WNBA players from 1997 to 2018 who had a history of ACL reconstruction before entering professional leagues. Body mass index (BMI), age, and position were collected for each player. Career data and performance statistics were likewise collected for each player’s entire WNBA career. A control group of WNBA players with no history of ACL injury were matched by position, BMI, and age at the time of WNBA debut. Statistics compared game utilization and performance to assess the impact of ACL reconstruction. Results: Athletes who sustained an ACL tear before entering the league played in fewer games per season in their first 3 professional seasons compared with healthy controls (24.2 ± 8.4 vs 28.2 ± 6.1; P = .02). Among athletes with a history of ACL reconstruction, 11 (26.2%) played only a single WNBA season, while no control athletes played in just 1 season. Additionally, athletes who had a previous ACL tear started significantly fewer games per season (9.0 ± 9.4 vs 14.0 ± 9.0; P < .01) and played fewer MPG (15.5 ± 7.2 vs 20.7 ± 5.5; P < .01) during their WNBA career. Athletes with a history of ACL tear had significantly shorter WNBA careers (4.8 ± 4.1 vs 8.1 ± 3.3 seasons; P < .001). Total professional play duration (WNBA + overseas) was significantly reduced in players with an ACL tear compared with controls ( P < .05). PER was not significantly different between cohorts at any time point. Conclusion: WNBA athletes with a history of an ACL tear before professional play had decreased career game utilization and workload throughout their career despite having similar PER compared with healthy controls.

Twenty-Year Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

2021 ◽  
pp. 036354652110273
Author(s):  
Joshua S. Everhart ◽  
Sercan Yalcin ◽  
Kurt P. Spindler
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Increased Risk ◽  
Patient Reported ◽  
The Mean ◽  
Anterior Cruciate

Background: Several long-term (≥20 years) follow-up studies after anterior cruciate ligament (ACL) reconstruction have been published in recent years, allowing for a systematic evaluation of outcomes. Purpose: To summarize outcomes at ≥20 years after ACL reconstruction and identify patient and surgical factors that affect these results. Study Design: Systematic review; Level of evidence, 4. Methods: Prospective studies of primary ACL reconstructions with hamstring or bone–patellar tendon—bone (BTB) autograft via an arthroscopic or a mini-open technique and with a mean follow-up of ≥20 years were identified. When possible, the mean scores for each outcome measure were calculated. Factors identified in individual studies as predictive of outcomes were described. Results: Five studies met the inclusion and exclusion criteria with a total of 2012 patients. The pooled mean follow-up for patient-reported outcome measures was 44.2% (range, 29.6%-92.7%) and in-person evaluation was 33.2% (range, 29.6%-48.9%). Four studies (n = 584) reported graft tears at a mean rate of 11.8% (range, 2%-18.5%) and 4 studies (n = 773) reported a contralateral ACL injury rate of 12.2% (range, 5.8%-30%). Repeat non-ACL arthroscopic surgery (4 studies; n = 177) to the ipsilateral knee occurred in 10.4% (range, 9.5%-18.3%) and knee arthroplasty (1 study; n = 217) in 5%. The pooled mean of the International Knee Documentation Committee subjective knee function (IKDC) score was 79.1 (SD, 21.8 [3 studies; n = 644]). In 2 studies (n?= 221), 57.5% of patients continued to participate in strenuous activities. The IKDC-objective score was normal or nearly normal in 82.3% (n = 496; 3 studies), with low rates of clinically significant residual laxity. Moderate-severe radiographic osteoarthritis (OA) (IKDC grade C or D) was present in 25.9% of patients (n = 605; 3 studies). Medial meniscectomy is associated with increased risk of radiographic OA. Radiographic OA severity is associated with worse patient-reported knee function, but the association with knee pain is unclear. Conclusion: Currently available prospective evidence for ACL reconstruction with hamstring or BTB autograft provides several insights into outcomes at 20 years. The rates of follow-up at 20 years range from 30% to 93%. IKDC-objective scores were normal or nearly normal in 82% and the mean IKDC-subjective score was 79 points.

scholarly journals No Association Between Risk of Anterior Cruciate Ligament Rupture and Selected Candidate Collagen Gene Variants in Female Elite Athletes From High-Risk Team Sports

2018 ◽  
Vol 47 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Einar Andreas Sivertsen ◽  
Kari Bente Foss Haug ◽  
Eirik Klami Kristianslund ◽  
Anne-Marie Siebke Trøseid ◽  
Jari Parkkari ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Elite Athletes ◽  
Cruciate Ligament ◽  
Team Sports ◽  
Acl Injury ◽  
Acl Rupture ◽  
Acl Injuries ◽  
Genes Encoding ◽  
Anterior Cruciate

Background: Several single-nucleotide variants (SNVs) in collagen genes have been reported as predisposing factors for anterior cruciate ligament (ACL) tears. However, the evidence is conflicting and does not support a clear association between genetic variants and risk of ACL ruptures. Purpose: To assess the association of previously identified candidate SNVs in genes encoding for collagen and the risk of ACL injury in a population of elite female athletes from high-risk team sports. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 851 female Norwegian and Finnish elite athletes from team sports were included from 2007 to 2011. ACL injuries acquired before inclusion in the cohort were registered by interview. The participants were followed prospectively through 2015 to record new complete ACL injuries. Six selected SNVs were genotyped ( COL1A1: rs1800012, rs1107946; COL3A1: rs1800255; COL5A1: rs12722, rs13946; COL12A1: rs970547). Results: No associations were found between ACL rupture and the SNVs tested. Conclusion: The study does not support a role of the 6 selected SNVs in genes encoding for collagen proteins as risk factors for ACL injury. Clinical Relevance: Genetic profiling to identify athletes at high risk for ACL rupture is not yet feasible.

scholarly journals Anterior Cruciate Ligament Rupture and Osteoarthritis Progression

2012 ◽  
Vol 6 (1) ◽  
pp. 295-300 ◽  
Author(s):  
James Min-Leong Wong ◽  
Tanvir Khan ◽  
Chethan S Jayadev ◽  
Wasim Khan ◽  
David Johnstone
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Degenerative Change ◽  
Acl Rupture ◽  
Osteoarthritis Progression ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Meniscal Damage ◽  
Acl Deficient

Anterior Cruciate Ligament (ACL) rupture is a common sporting injury that frequently affects young, athletic patients. Apart from the functional problems of instability, patients with ACL deficient knees also develop osteoarthritis. Although this is frequently cited as an indication for ACL reconstruction, the relationship between ACL rupture, reconstruction and the instigation and progression of articular cartilage degenerative change is controversial. The purpose of this paper is to review the published literature with regards ACL rupture and the multifactorial causes for osteoarthritis progression, and whether or not this is slowed or stopped by ACL reconstruction. There is no evidence in the published literature to support the view that ACL reconstruction prevents osteoarthritis, although it may prevent further meniscal damage. It must be recognised that this conclusion is based on the current literature which has substantial methodological limitations.

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