scholarly journals Higher aggrecan 1-F21 epitope concentration in synovial fluid early after anterior cruciate ligament injury is associated with worse knee cartilage quality assessed by gadolinium enhanced magnetic resonance imaging 20 years later

2020 ◽  
Author(s):  
Paul Neuman ◽  
Staffan Larsson ◽  
L Stefan Lohmander ◽  
André Struglics
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Synovial Fluid ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Anterior Cruciate

Abstract Background. To investigate if cartilage related biomarkers in synovial fluid are associated with knee cartilage status 20 years after an anterior cruciate ligament (ACL) injury.Methods. We studied 25 patients with a complete ACL rupture without subsequent ACL reconstruction or radiographic knee OA. All had a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) 20 years after the ACL injury, using the T1 transverse relaxation time in the presence of gadolinium (T1Gd) which estimates the concentration of glycosaminoglycans in hyaline cartilage. Synovial fluid samples were aspirated acutely (between 0 and 18 days) and during 1 to 5 follow up visits between 0.5 and 7.5 years after injury. We quantified synovial fluid concentrations of aggrecan (epitopes 1-F21 and ARGS), cartilage oligomeric matrix protein, matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 by immunoassays, and sulfated glycosaminoglycans by Alcian blue precipitation. Western blot was used for qualitative analyses of aggrecan fragments in synovial fluid and cartilage samples.Results. Western blot indicated that the 1-F21 epitope was located within the chondroitin sulfate 2 region of aggrecan. Linear regression analyses (adjusted for age, sex, body mass index and time between injury and sampling) showed that acute higher synovial fluid 1-F21-aggrecan concentrations were associated with shorter T1Gd values 20 years after injury, i.e. inferior cartilage quality (standardized effects between -0.67 and -1.0). No other statistically significant association was found between molecular biomarkers and T1Gd values. Conclusion. Higher acute synovial fluid 1-F21-aggrecan concentrations in ACL injured patients, who managed to cope without ACL reconstruction and were without radiographic knee OA, were associated with inferior knee cartilage quality assessed by dGEMRIC 20 years after injury.

scholarly journals Higher aggrecan 1-F21 epitope concentration in synovial fluid early after anterior cruciate ligament injury is associated with worse knee cartilage quality assessed by gadolinium enhanced magnetic resonance imaging 20 years later

2020 ◽  
Author(s):  
Paul Neuman ◽  
Staffan Larsson ◽  
L Stefan Lohmander ◽  
André Struglics
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Synovial Fluid ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Anterior Cruciate

Abstract Objective. To investigate if cartilage related biomarkers in synovial fluid are associated with knee cartilage status 20 years after an anterior cruciate ligament (ACL) injury. Methods. We studied 25 patients with a complete ACL rupture without subsequent ACL reconstruction or radiographic knee OA. All had a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) 20 years after the ACL injury, using the T1 transverse relaxation time in the presence of gadolinium (T1Gd) which estimates the concentration of glycosaminoglycans in hyaline cartilage. Synovial fluid samples were aspirated acutely (between 0 and 18 days) and during 1 to 5 follow up visits between 0.5 and 7.5 years after injury. We quantified synovial fluid concentrations of aggrecan (epitopes 1-F21 and ARGS), cartilage oligomeric matrix protein, matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 by immunoassays, and sulfated glycosaminoglycans by Alcian blue precipitation. Results. Linear regression analyses (adjusted for age, sex, body mass index and time between injury and sampling) showed that acute higher synovial fluid 1-F21-aggrecan concentrations were associated with shorter T1Gd values 20 years after injury, i.e. inferior cartilage quality (standardized effects between -0.67 and -1.0). No other statistically significant association was found between molecular biomarkers and T1Gd values. Conclusion. Higher acute synovial fluid 1-F21-aggrecan concentrations in ACL injured patients, who managed to cope without ACL reconstruction and were without radiographic knee OA, were associated with worse knee cartilage quality assessed by dGEMRIC 20 years after injury.

scholarly journals Higher aggrecan 1-F21 epitope concentration in synovial fluid early after anterior cruciate ligament injury is associated with worse knee cartilage quality assessed by gadolinium enhanced magnetic resonance imaging 20 years later

2020 ◽  
Author(s):  
Paul Neuman ◽  
Staffan Larsson ◽  
L Stefan Lohmander ◽  
André Struglics
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Synovial Fluid ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Anterior Cruciate

Abstract Background. To investigate if cartilage related biomarkers in synovial fluid are associated with knee cartilage status 20 years after an anterior cruciate ligament (ACL) injury.Methods. We studied 25 patients with a complete ACL rupture without subsequent ACL reconstruction or radiographic knee OA. All had a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) 20 years after the ACL injury, using the T1 transverse relaxation time in the presence of gadolinium (T1Gd) which estimates the concentration of glycosaminoglycans in hyaline cartilage. Synovial fluid samples were aspirated acutely (between 0 and 18 days) and during 1 to 5 follow up visits between 0.5 and 7.5 years after injury. We quantified synovial fluid concentrations of aggrecan (epitopes 1-F21 and ARGS), cartilage oligomeric matrix protein, matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 by immunoassays, and sulfated glycosaminoglycans by Alcian blue precipitation. Western blot was used for qualitative analyses of aggrecan fragments in synovial fluid and cartilage samples.Results. Western blot indicated that the 1-F21 epitope was located within the chondroitin sulfate 2 region of aggrecan. Linear regression analyses (adjusted for age, sex, body mass index and time between injury and sampling) showed that acute higher synovial fluid 1-F21-aggrecan concentrations were associated with shorter T1Gd values 20 years after injury, i.e. inferior cartilage quality (standardized effects between -0.67 and -1.0). No other statistically significant association was found between molecular biomarkers and T1Gd values. Conclusion. Higher acute synovial fluid 1-F21-aggrecan concentrations in ACL injured patients, who managed to cope without ACL reconstruction and were without radiographic knee OA, were associated with inferior knee cartilage quality assessed by dGEMRIC 20 years after injury.

scholarly journals Higher aggrecan 1-F21 epitope concentration in synovial fluid early after anterior cruciate ligament injury is associated with worse knee cartilage quality assessed by gadolinium enhanced magnetic resonance imaging 20 years later

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Paul Neuman ◽  
Staffan Larsson ◽  
L. Stefan Lohmander ◽  
André Struglics
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Synovial Fluid ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Knee Oa ◽  
Anterior Cruciate

Abstract Background To investigate if cartilage related biomarkers in synovial fluid are associated with knee cartilage status 20 years after an anterior cruciate ligament (ACL) injury. Methods We studied 25 patients with a complete ACL rupture without subsequent ACL reconstruction or radiographic knee OA. All had a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) 20 years after the ACL injury, using the T1 transverse relaxation time in the presence of gadolinium (T1Gd) which estimates the concentration of glycosaminoglycans in hyaline cartilage. Synovial fluid samples were aspirated acutely (between 0 and 18 days) and during 1 to 5 follow up visits between 0.5 and 7.5 years after injury. We quantified synovial fluid concentrations of aggrecan (epitopes 1-F21 and ARGS), cartilage oligomeric matrix protein, matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 by immunoassays, and sulfated glycosaminoglycans by Alcian blue precipitation. Western blot was used for qualitative analyses of aggrecan fragments in synovial fluid and cartilage samples. Results Western blot indicated that the 1-F21 epitope was located within the chondroitin sulfate 2 region of aggrecan. Linear regression analyses (adjusted for age, sex, body mass index and time between injury and sampling) showed that acute higher synovial fluid 1-F21-aggrecan concentrations were associated with shorter T1Gd values 20 years after injury, i.e. inferior cartilage quality (standardized effects between − 0.67 and − 1.0). No other statistically significant association was found between molecular biomarkers and T1Gd values. Conclusion Higher acute synovial fluid 1-F21-aggrecan concentrations in ACL injured patients, who managed to cope without ACL reconstruction and were without radiographic knee OA, were associated with inferior knee cartilage quality assessed by dGEMRIC 20 years after injury.

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears

2021 ◽  
pp. 194173812110295
Author(s):  
Patrick Ward ◽  
Peter Chang ◽  
Logan Radtke ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. Evidence Acquisition: A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Study Design: Clinical review. Level of Evidence: Level 4. Results: The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Conclusion: Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. Strength of Recommendation Taxonomy: 2.

scholarly journals Diagnostic accuracy of magnetic resonance imaging in detecting anterior cruciate ligament injuries

2017 ◽  
Vol 26 (3) ◽  
pp. 218-23
Author(s):  
Ashfaq Ahmed ◽  
Muhammad A. Razzaque ◽  
Muhammad Kaleem ◽  
Atiq U. Zaman ◽  
Rizwan Akram ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Resonance Imaging ◽  
Anterior Cruciate

Background: The anterior cruciate ligament (ACL) stabilizes the joint during hyperextension and prevents anterior translation over femur. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting ACL injury by taking arthroscopy as gold standard in patients with traumatic knee injury.Methods: Patients fulfilling the study criteria were treated with clinical examination, MRI and then arthroscopy at the Department of Orthopedics and Spine in the Ghurki Trust Teaching Hospital, Lahore. The accuracy, sensitivity and specificity of MRI in diagnosing  the anterior cruciate ligament injury were calculated based on arthroscopic findings. All the data were analyzed using SPSS 17.0 version.Results: A total 185 patients were included. 91.1% were males and 8.9% were females with Mean age of 28.25±0.433. The accuracy of MRI in diagnosing the anterior cruciate ligament was 91.89%, with sensitivity of 93.33%, specificity of 85.71%, positive predictive value of 96.55% and the negative predictive value  of 75%.Conclusion: MRI is accurate and non-invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation to patients with suspicion of ACL injury.

scholarly journals Femoral notch and proximal tibial morphology and their relationship with an anterior cruciate ligament injury in the Indian population: A magnetic resonance imaging-based study

2020 ◽  
Vol 1 ◽  
pp. 193-198
Author(s):  
Vishal Huggi ◽  
K. Yogesh ◽  
George Jacob ◽  
Shailesh Pai ◽  
Ajith Kumar ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Resonance Imaging ◽  
Posterior Tibial ◽  
Lateral Posterior ◽  
Anterior Cruciate

Objectives: We aim to study the incidence of anterior cruciate ligament (ACL) injury to proximal tibia bone morphology in Indian patients. Materials and Methods: Forty male subjects who sustained non-contact ACL injury who presented to our center between October 2015 and December 2016 studied and compared to 40 non-ACL injury knee magnetic resonance imaging scans. Notch morphology and both medial and lateral posterior tibial slope measurements were performed and studied. Results: We noted that the difference in notch depth and notch angle between the two groups was not significant. There was a statistically significant higher incidence of ACL injury in patients with smaller notch widths. Both an increased medial and lateral posterior tibial slope did not demonstrate a statistically significant incidence in ACL injury. Conclusion: Notch width is a major contributing risk factor for ACL injury in Indian patients. This is in agreement with previously published literature.

scholarly journals Cartilage Subsurface Changes to Magnetic Resonance Imaging UTE-T2* 2 Years After Anterior Cruciate Ligament Reconstruction Correlate With Walking Mechanics Associated With Knee Osteoarthritis

2018 ◽  
Vol 46 (3) ◽  
pp. 565-572 ◽  
Author(s):  
Matthew R. Titchenal ◽  
Ashley A. Williams ◽  
Eric F. Chehab ◽  
Jessica L. Asay ◽  
Jason L. Dragoo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Mechanical Alignment ◽  
Resonance Imaging ◽  
Knee Cartilage ◽  
Varus Alignment ◽  
Medial Knee ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury increases risk for posttraumatic knee osteoarthritis (OA). Quantitative ultrashort echo time enhanced T2* (UTE-T2*) mapping shows promise for early detection of potentially reversible subsurface cartilage abnormalities after ACL reconstruction (ACLR) but needs further validation against established clinical metrics of OA risk such as knee adduction moment (KAM) and mechanical alignment. Hypothesis: Elevated UTE-T2* values in medial knee cartilage 2 years after ACLR correlate with varus alignment and higher KAM during walking. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Twenty patients (mean age, 33.1 ± 10.5 years; 11 female) 2 years after ACLR underwent 3.0-T knee magnetic resonance imaging (MRI), radiography, and gait analysis, after which mechanical alignment was measured, KAM during walking was calculated, and UTE-T2* maps were generated. The mechanical axis and the first and second peaks of KAM (KAM1 and KAM2, respectively) were tested using linear regressions for correlations with deep UTE-T2* values in the central and posterior medial femoral condyle (cMFC and pMFC, respectively) and central medial tibial plateau (cMTP). UTE-T2* values from ACL-reconstructed patients were additionally compared with those of 14 uninjured participants (mean age, 30.9 ± 8.9 years; 6 female) using Mann-Whitney U and standard t tests. Results: Central weightbearing medial compartment cartilage of ACL-reconstructed knees was intact on morphological MRI. Mean UTE-T2* values were elevated in both the cMFC and pMFC of ACL-reconstructed knees compared with those of uninjured knees ( P = .003 and P = .012, respectively). In ACL-reconstructed knees, UTE-T2* values of cMFC cartilage positively correlated with increasing varus alignment ( R = 0.568). Higher UTE-T2* values in cMFC and cMTP cartilage of ACL-reconstructed knees also correlated with greater KAM1 ( R = 0.452 and R = 0.463, respectively) and KAM2 ( R = 0.465 and R = 0.764, respectively) and with KAM2 in pMFC cartilage ( R = 0.602). Conclusion: Elevated deep UTE-T2* values of medial knee cartilage 2 years after ACLR correlate with 2 clinical markers of increased risk of medial knee OA. These results support the clinical utility of MRI UTE-T2* for early diagnosis of subsurface cartilage abnormalities. Longitudinal follow-up of larger cohorts is needed to determine the predictive and staging potential of UTE-T2* for posttraumatic OA.

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