Abstract
Reconstruction is the gold standard treatment for those who have experienced a tear of the anterior cruciate ligament. Despite advancements in surgical technique and rehabilitation, a negative consequence of anterior ligament reconstruction (ACLr) is early onset osteoarthritis of the tibiofemoral joint and patellofemoral joint (PFJ). There is evidence that altered patella alignment may be contributory to early onset patellofemoral joint osteoarthritis. A negative consequence of patella malalignment is that contact between the patella and trochlea could be reduced, thereby exposing the joint to elevated stress (force per unit area). PURPOSE: The purpose of the current study was two-fold: 1) to compare PFJ alignment (lateral tilt and displacement) and contact area between females post-ACLr and healthy controls, and 2) to assess the association between measures of patellar alignment and contact area.. METHODS: Forty females between the ages of 18-35 participated (20 post-ACLr, 20 matched controls) Participants underwent magnetic resonance imaging of the PFJ at 0°, 20°, 40°, and 60° of knee flexion under loaded conditions (35% bwt). Measures of PFJ contact area, lateral patella tilt and lateral patella displacement were compared between groups and knee flexion angles using separate 2 X 4 ANOVAs with repeated measures. Pearson correlations were used to evaluate the associations among measures of patella alignment and contact area at each knee flexion angle. RESULTS: Compared to the control group, females post-ACLr exhibited significantly elevated lateral patella tilt (differences ranging from 3.7° to 4.9° across all knee flexion angles) and reduced contact area (differences ranging from 21.6% to 29.1%). No group differences in lateral patellar displacement were observed. Lateral patellar tilt was negatively correlated with contact area from 20° to 60° of knee flexion (r-values ranging from 0.59 to 0.66). CONCLUSION: Females post-ACLr exhibit excessive lateral patella tilt and reduced PFJ contact area compared to a control group. The observed reduction in contact area could expose the PFJ to elevated joint stress and may be a contributing factor with respect to early-onset osteoarthritis in this population.
Recommended Citation
Demirjian, Thomas; Tu, Olivia; Northrup, Gillian; and Powers, Christopher
(2024)
"Females Who Have Undergone ACL Reconstruction Exhibit Altered Patellofemoral Joint Alignment and Reduced Contact: Implications for Early Onset Osteoarthritis,"
International Journal of Exercise Science: Conference Proceedings: Vol. 14:
Iss.
4, Article 50.
Available at:
https://digitalcommons.wku.edu/ijesab/vol14/iss4/50
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Health and Physical Education Commons, Medical Education Commons, Sports Sciences Commons