Abstract
Background/Aims: Following anterior cruciate ligament reconstruction (ACLR), there is a risk of developing Post-Traumatic Osteoarthritis (PTOA). Although the role of bone health in PTOA development is still not understood, if altered bone geometries and bone mineral densities exist there are potential implications for osteoarthritis pathogenesis. Considering cortical and trabecular area deficits are key pathophysiological changes in pathological bone conditions it is pertinent to measure this in a population where changes could be observed and influence PTOA disease pathogenesis. Consequently, the aim of this study was to establish if there are differences in cortical and trabecular bone area and density following ACLR.
Methods: Thirty-two participants (18 female, 14 male; age: 27 ± 6 years, body mass index: 25.4 ± 3.9 kg/m2, time since ACLR: 23 (12-79) months) were recruited. A peripheral quantitative computerised tomography scanner was used to scan the reconstructed leg and uninjured contralateral leg at 66% of the tibia, and at 20% (femur20%) and 50% (femur50%) of the femur. To accurately define the periosteal contour of the bone, a contour threshold was set at 280 mg/cm³. For trabecular density and area measurement, cortical bone was separated from trabecular bone using sequential contour detection whilst an inner threshold of 400 mg/cm³ was applied. For cortical bone density and area measurement, an inner threshold of 690 mg/cm³ was used. Additionally, a 3 × 3 filter was implemented to reduce image noise and enhance image quality during the analysis.
Results: Cortical bone area was significantly lower at all scan sites in the reconstructed leg in comparison to the contralateral leg, however, there were no differences in cortical bone density between legs at any scan site (Table 1). Trabecular bone density was significantly lower in the reconstructed leg at femur20% in comparison to the contralateral leg. Trabecular bone area was significantly greater in the contralateral leg at femur20% in comparison to the uninjured contralateral leg.
Conclusion: A reduced cortical bone area and trabecular bone density in the ACLR leg may be a long-term consequence of disuse and underloading following injury and subsequent surgery. The potential implication for future PTOA risk warrants further investigation.
Methods: Thirty-two participants (18 female, 14 male; age: 27 ± 6 years, body mass index: 25.4 ± 3.9 kg/m2, time since ACLR: 23 (12-79) months) were recruited. A peripheral quantitative computerised tomography scanner was used to scan the reconstructed leg and uninjured contralateral leg at 66% of the tibia, and at 20% (femur20%) and 50% (femur50%) of the femur. To accurately define the periosteal contour of the bone, a contour threshold was set at 280 mg/cm³. For trabecular density and area measurement, cortical bone was separated from trabecular bone using sequential contour detection whilst an inner threshold of 400 mg/cm³ was applied. For cortical bone density and area measurement, an inner threshold of 690 mg/cm³ was used. Additionally, a 3 × 3 filter was implemented to reduce image noise and enhance image quality during the analysis.
Results: Cortical bone area was significantly lower at all scan sites in the reconstructed leg in comparison to the contralateral leg, however, there were no differences in cortical bone density between legs at any scan site (Table 1). Trabecular bone density was significantly lower in the reconstructed leg at femur20% in comparison to the contralateral leg. Trabecular bone area was significantly greater in the contralateral leg at femur20% in comparison to the uninjured contralateral leg.
Conclusion: A reduced cortical bone area and trabecular bone density in the ACLR leg may be a long-term consequence of disuse and underloading following injury and subsequent surgery. The potential implication for future PTOA risk warrants further investigation.
| Original language | English |
|---|---|
| Pages | 148-149 |
| Number of pages | 2 |
| DOIs | |
| Publication status | Published - 28 Apr 2025 |
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Physiology (medical)
- Rehabilitation
- Biomedical Engineering
- Rheumatology
