Abnormal Biomechanics at 6 Months Are Associated With Cartilage Degeneration at 3 Years After Anterior Cruciate Ligament Reconstruction

Tomohiro Shimizu, Michael A. Samaan, Matthew S. Tanaka, Valentina Pedoia, Richard B. Souza, Xiaojuan Li, C. Benjamin Ma

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Purpose: To investigate the changes in landing biomechanics over a 3-year period and their correlation with cartilage degenerative changes in the medial tibiofemoral joint of the knee after anterior cruciate ligament reconstruction (ACLR) using magnetic resonance T1ρ mapping. Methods: Thirty-one anterior cruciate ligament–injured patients underwent magnetic resonance imaging of the injured knee before ACLR and 3 years after ACLR, as well as biomechanical analysis of a drop-landing task at 6 months and 3 years after ACLR. Sixteen healthy individuals were recruited and underwent knee magnetic resonance imaging and biomechanical assessment during a drop-landing task. T1ρ cartilage relaxation times were calculated for the medial femur and tibia. Results: ACLR patients exhibited increased peak vertical ground reaction force (VGRF), VGRF impulse, peak knee flexion moment (KFM), and KFM impulse from 6 months to 3 years (P <.001 for each). Although the ACLR knees showed significantly lower peak VGRF and KFM at 6 months (P <.001 for both) when compared with the controls, there were no significant differences at 3 years. At 3 years, ACLR patients showed higher T1ρ values over the medial femur (P <.001) and tibia (P =.012) when compared with their preoperative values and with healthy control values. Within the ACLR group, side-to-side differences in peak VGRF and sagittal knee biomechanics at 6 months were associated with increased T1ρ values from baseline to 3 years. Conclusions: The results of this longitudinal study show that landing biomechanics are altered after ACLR but biomechanical abnormalities tend to recover at 3 years after ACLR. Differences in lower-extremity mechanics during a landing task at 6 months may be associated with cartilage degeneration at 3 years after anterior cruciate ligament injury and reconstruction. Level of Evidence: Level II, prospective trial.

Original languageEnglish
Pages (from-to)511-520
Number of pages10
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Issue number2
StatePublished - Feb 2019

Bibliographical note

Funding Information:
The authors report the following potential conflicts of interest or sources of funding: This study was funded by National Institutes of Health–National Institute of Arthritis and Musculoskeletal and Skin Diseases P50 AR060752 and F32 AR069458 and the American Orthopaedic Society for Sports Medicine Cartilage Initiative Grant. C.B.M. and X.L. receive support from NIH and AOSSM. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

Publisher Copyright:
© 2019 Arthroscopy Association of North America

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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