Factors Affecting the Femoral Cartilage Thickness After Anterior Cruciate Ligament Reconstruction
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ORIGINAL ARTICLE
Factors Affecting the Femoral Cartilage Thickness After Anterior Cruciate Ligament Reconstruction Ahmet Üşen1 · Sena Tolu1 Received: 29 June 2020 / Accepted: 14 September 2020 © Indian Orthopaedics Association 2020
Abstract Background This study aimed to evaluate the changes in the distal femoral cartilage thickness in patients that underwent anterior cruciate ligament reconstruction (ACLR) and to analyze their association with concomitant meniscal surgery, knee muscle strength, kinesophobia, and physical activity level. Methods The demographic characteristics and surgical data of 47 male patients that underwent unilateral ACLR (mean, 27.55 ± 5.63; range, 18–40 years) were evaluated. The patients were assessed in three groups depending on surgery: isolated ACLR (n = 15), ACLR + partial medial meniscus resection (ACLR&M) (n = 16), and ACLR + medial meniscus repair (ACLR&MR) (n = 16). The medial (MCCT), intercondylar (ICCT), and lateral (LCCT) femoral cartilage thicknesses on both limbs were measured using ultrasonography. The extensor and flexor muscles strength of the knees was assessed using an isokinetic dynamometer at 60°/s. The physical activity level was evaluated by the International Physical Activity Questionnaire (IPAQ) short form and Tegner Activity Scale (TAS). The fear of movement was assessed by the Tampa Scale for Kinesiophobia Questionnaire (TSKQ). Results The postoperative mean follow-up duration was 32.24 ± 9.17 months. MCCT and LCCT were significantly decreased in the ACLR&M group (p 0.05). Conclusion The results showed partial meniscectomy and meniscus repair at the time of ACLR as important risk factors for decreased chondral thickness. Keywords Anterior cruciate ligament reconstruction · Femoral cartilage thickness · Ultrasonography · Meniscal surgery
Introduction Anterior cruciate ligament (ACL) injuries are common, particularly in physically active young populations. ACL is a major stabilizer of the knee since it resists anterior tibial translation and rotational loads. ACL reconstruction (ACLR) is performed to restore knee biomechanics and * Ahmet Üşen [email protected] Sena Tolu [email protected] 1
Department of Physical, Medicine and Rehabilitation, Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bagcilar, Istanbul 34214, Turkey
allow patients to recover their pre-injury activity levels [1, 2]. Although some studies have been reported satisfactory short- and mid-term results, the protective effects of ACLR on the cartilage structure of the knee are contradictory [1–4]. Wipfler et al. reported their long-term results with a mean follow-up of 8.8 years in patients with ACLR and noted no difference of articular cartilage and meniscal degeneration between the operated and healthy knees [3]. However, Ichiba and Kishimoto found increased cartilage degeneration risk in patients that had undergone ACLR and presented with cartilage or meniscal injury [5]. An ultrasound examination has been reported to be useful for
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