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Title: Lateral displacement, sulcus angle and trochlear angle are associated with early patellofemoral osteoarthritis following anterior cruciate ligament reconstruction.
Authors: Whitehead, Timothy
Other Authors: Macri, Erin
Culvenor, Adam
Morris, Hayden
Russell, Trevor
Khan, Karim
Crossley, Kay
Keywords: Anterior Cruciate Ligament
Patellofemoral Joint
Patellofemoral Osteoarthritis
ACL Reconstruction
Patellofemoral Alignment
Trochlear Morphology
Post-Traumatic PFOA
Post-Traumatic Patellofemoral Osteoarthritis
Early Intervention Strategies
Radiographic Features
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: May-2017
Publisher: Springer
Citation: Knee Surg Sports Traumatol Arthrosc. 2017 May 9
Abstract: PURPOSE: Patellofemoral osteoarthritis (PFOA) occurs in approximately half of anterior cruciate ligament (ACL)-injured knees within 10-15 years of trauma. Risk factors for post-traumatic PFOA are poorly understood. Patellofemoral alignment and trochlear morphology may be associated with PFOA following ACL reconstruction (ACLR), and understanding these relationships, particularly early in the post-surgical time period, may guide effective early intervention strategies. In this study, patellofemoral alignment and trochlear morphology were investigated in relation to radiographic features of early PFOA 1-year post-ACLR. METHODS: Participants (aged 18-50 years) had undergone ACLR approximately 1 year prior to being assessed. Early PFOA was defined as presence of a definite patellofemoral osteophyte on lateral or skyline radiograph. Sagittal and axial plane alignment and trochlear morphology were estimated using MRI. Using logistic regression, the relationship between alignment or morphology and presence of osteophytes was evaluated. RESULTS: Of 111 participants [age 30 ± 8.5; 41 (37%) women], 19 (17%) had definite osteophytes, only two of whom had had patellofemoral chondral lesions noted intra-operatively. One measure of patellar alignment (bisect offset OR 1.1 [95% confidence interval 1.0, 1.2]) and two measures of trochlear morphology (sulcus angle OR 1.1 [1.0, 1.2], trochlear angle OR 1.2 [1.0, 1.5]) were associated with patellofemoral osteophytes. CONCLUSIONS: Patellofemoral malalignment and/or altered trochlear morphology were associated with PFOA 1 year following ACLR compared to individuals post-ACLR without these features. Clarifying the role of alignment and morphology in post-traumatic PFOA may contribute to improving early intervention strategies aimed at secondary prevention. LEVEL OF EVIDENCE: IV.
DOI: 10.1007/s00167-017-4571-1
PubMed URL:
ISSN: 0942-2056
Journal Title: Knee Surgery, Sports Traumatology, Arthroscopy
Type: Journal Article
Affiliated Organisations: Department of Family Practice, Centre for Hip Health and Mobility, University of British Columbia, 2635 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
Institute of Anatomy, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria.
School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, 3086, Australia.
Park Clinic Orthopaedics, St. Vincent's Private Hospital, 166 Gipps Street, East Melbourne, VIC, 3002, Australia.
Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, QLD, 4072, Australia.
School of Allied Health, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC, 3086, Australia.
Type of Clinical Study or Trial: Cross-Sectional Study
Appears in Collections:Musculoskeletal

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