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Published in: Skeletal Radiology 11/2012

01-11-2012 | Scientific Article

Non-traumatic anterior cruciate ligament abnormalities and their relationship to osteoarthritis using morphological grading and cartilage T2 relaxation times: data from the Osteoarthritis Initiative (OAI)

Authors: Keegan K. Hovis, Hamza Alizai, Seng-Choe Tham, Richard B. Souza, Michael C. Nevitt, Charles E. McCulloch, Thomas M. Link

Published in: Skeletal Radiology | Issue 11/2012

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Abstract

Objectives

The aim of this work was to study anterior cruciate ligament (ACL) degeneration in relation to MRI-based morphological knee abnormalities and cartilage T2 relaxation times in subjects with symptomatic osteoarthritis.

Methods

Two radiologists screened the right knee MRI of 304 randomly selected participants in the Osteoarthritis Initiative cohort with symptomatic OA, for ACL abnormalities. Of the 52 knees with abnormalities, 28 had mucoid degeneration, 12 had partially torn ACLs, and 12 had completely torn ACLs. Fifty-three randomly selected subjects with normal ACLs served as controls. Morphological knee abnormalities were graded using the WORMS score. Cartilage was segmented and compartment-specific T2 values were calculated.

Results

Compared to normal ACL knees, those with ACL abnormalities had a greater prevalence of, and more severe, cartilage, meniscal, bone marrow, subchondral cyst, and medial collateral ligament lesions (all p < 0.05). T2 measurements did not significantly differ by ACL status.

Conclusions

ACL abnormalities were associated with more severe degenerative changes, likely because of greater joint instability. T2 measurements may not be well suited to assess advanced cartilage degeneration.
Literature
1.
go back to reference Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.PubMedCrossRef Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum. 2008;58(1):26–35.PubMedCrossRef
2.
go back to reference Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. Am J Med. 1997;103(6A):25S–30S.PubMedCrossRef Lane NE, Thompson JM. Management of osteoarthritis in the primary-care setting: an evidence-based approach to treatment. Am J Med. 1997;103(6A):25S–30S.PubMedCrossRef
3.
go back to reference Cooper C, Snow S, McAlindon TE, Kellingray S, Stuart B, Coggon D, et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000;43(5):995–1000.PubMedCrossRef Cooper C, Snow S, McAlindon TE, Kellingray S, Stuart B, Coggon D, et al. Risk factors for the incidence and progression of radiographic knee osteoarthritis. Arthritis Rheum. 2000;43(5):995–1000.PubMedCrossRef
4.
go back to reference Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM. Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum. 2009;61(4):459–67.PubMedCrossRef Tanamas S, Hanna FS, Cicuttini FM, Wluka AE, Berry P, Urquhart DM. Does knee malalignment increase the risk of development and progression of knee osteoarthritis? A systematic review. Arthritis Rheum. 2009;61(4):459–67.PubMedCrossRef
5.
go back to reference Chitnavis J, Sinsheimer JS, Clipsham K, Loughlin J, Sykes B, Burge PD, et al. Genetic influences in end-stage osteoarthritis. Sibling risks of hip and knee replacement for idiopathic osteoarthritis. J Bone Joint Surg Br. 1997;79(4):660–4.PubMedCrossRef Chitnavis J, Sinsheimer JS, Clipsham K, Loughlin J, Sykes B, Burge PD, et al. Genetic influences in end-stage osteoarthritis. Sibling risks of hip and knee replacement for idiopathic osteoarthritis. J Bone Joint Surg Br. 1997;79(4):660–4.PubMedCrossRef
6.
go back to reference Zantop T, Petersen W, Sekiya JK, Musahl V, Fu FH. Anterior cruciate ligament anatomy and function relating to anatomical reconstruction. Knee Surg Sports Traumatol Arthrosc. 2006;14(10):982–92.PubMedCrossRef Zantop T, Petersen W, Sekiya JK, Musahl V, Fu FH. Anterior cruciate ligament anatomy and function relating to anatomical reconstruction. Knee Surg Sports Traumatol Arthrosc. 2006;14(10):982–92.PubMedCrossRef
7.
go back to reference Hill CL, Seo GS, Gale D, Totterman S, Gale ME, Felson DT. Cruciate ligament integrity in osteoarthritis of the knee. Arthritis Rheum. 2005;52(3):794–9.PubMedCrossRef Hill CL, Seo GS, Gale D, Totterman S, Gale ME, Felson DT. Cruciate ligament integrity in osteoarthritis of the knee. Arthritis Rheum. 2005;52(3):794–9.PubMedCrossRef
8.
go back to reference Kumar A, Bickerstaff D, Grimwood J. Mucoid cystic degeneration of the cruciate ligament. J Bone Joint Surg Br. 1999;81:304–5.PubMedCrossRef Kumar A, Bickerstaff D, Grimwood J. Mucoid cystic degeneration of the cruciate ligament. J Bone Joint Surg Br. 1999;81:304–5.PubMedCrossRef
9.
go back to reference Melloni P, Valls R, Yuguero M, Saez A. Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle. Skeletal Radiol. 2004;33(6):359–62.PubMedCrossRef Melloni P, Valls R, Yuguero M, Saez A. Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle. Skeletal Radiol. 2004;33(6):359–62.PubMedCrossRef
10.
go back to reference Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med. 1994;22(5):632–44.PubMedCrossRef Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med. 1994;22(5):632–44.PubMedCrossRef
11.
go back to reference Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50(10):3145–52.PubMedCrossRef Lohmander LS, Ostenberg A, Englund M, Roos H. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum. 2004;50(10):3145–52.PubMedCrossRef
12.
go back to reference Maletius W, Messner K. Eighteen- to twenty-four-year follow-up after complete rupture of the anterior cruciate ligament. Am J Sports Med. 1999;27(6):711–7.PubMed Maletius W, Messner K. Eighteen- to twenty-four-year follow-up after complete rupture of the anterior cruciate ligament. Am J Sports Med. 1999;27(6):711–7.PubMed
13.
go back to reference Wong S, Steinbach L, Zhao J, Stehling C, Ma CB, Link TM. Comparative study of imaging at 3.0 T versus 1.5 T of the knee. Skeletal Radiol. 2009;38(8):761–9.PubMedCrossRef Wong S, Steinbach L, Zhao J, Stehling C, Ma CB, Link TM. Comparative study of imaging at 3.0 T versus 1.5 T of the knee. Skeletal Radiol. 2009;38(8):761–9.PubMedCrossRef
14.
go back to reference Link TM, Sell CA, Masi JN, Phan C, Newitt D, Lu Y, et al. 3.0 vs 1.5 T MRI in the detection of focal cartilage pathology--ROC analysis in an experimental model. Osteoarthritis Cartilage. 2006;14(1):63–70.PubMedCrossRef Link TM, Sell CA, Masi JN, Phan C, Newitt D, Lu Y, et al. 3.0 vs 1.5 T MRI in the detection of focal cartilage pathology--ROC analysis in an experimental model. Osteoarthritis Cartilage. 2006;14(1):63–70.PubMedCrossRef
15.
go back to reference Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, et al. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage. 2004;12(3):177–90.PubMedCrossRef Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, et al. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage. 2004;12(3):177–90.PubMedCrossRef
16.
go back to reference Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG. The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis. 2008;67(2):206–11.PubMedCrossRef Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG. The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis. 2008;67(2):206–11.PubMedCrossRef
17.
go back to reference Stahl R, Luke A, Li X, Carballido-Gamio J, Ma CB, Majumdar S, et al. T1rho, T2 and focal knee cartilage abnormalities in physically active and sedentary healthy subjects versus early OA patients--a 3.0-Tesla MRI study. Eur Radiol. 2009;19(1):132–43.PubMedCrossRef Stahl R, Luke A, Li X, Carballido-Gamio J, Ma CB, Majumdar S, et al. T1rho, T2 and focal knee cartilage abnormalities in physically active and sedentary healthy subjects versus early OA patients--a 3.0-Tesla MRI study. Eur Radiol. 2009;19(1):132–43.PubMedCrossRef
18.
go back to reference Mosher TJ, Liu Y, Torok CM. Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running. Osteoarthritis Cartilage. 2010;18(3):358–64.PubMedCrossRef Mosher TJ, Liu Y, Torok CM. Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running. Osteoarthritis Cartilage. 2010;18(3):358–64.PubMedCrossRef
19.
go back to reference Mamisch TC, Hughes T, Mosher TJ, Mueller C, Trattnig S, Boesch C, et al. T2 star relaxation times for assessment of articular cartilage at 3 T: a feasibility study. Skeletal Radiol. 2012;41(3):287–92.PubMedCrossRef Mamisch TC, Hughes T, Mosher TJ, Mueller C, Trattnig S, Boesch C, et al. T2 star relaxation times for assessment of articular cartilage at 3 T: a feasibility study. Skeletal Radiol. 2012;41(3):287–92.PubMedCrossRef
20.
go back to reference Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46(2):153–62.PubMedCrossRef Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46(2):153–62.PubMedCrossRef
21.
go back to reference Stehling C, Liebl H, Krug R, Lane NE, Nevitt MC, Lynch J, et al. Patellar cartilage: T2 values and morphologic abnormalities at 3.0-T MR imaging in relation to physical activity in asymptomatic subjects from the osteoarthritis initiative. Radiology. 2010;254(2):509–20.PubMedCrossRef Stehling C, Liebl H, Krug R, Lane NE, Nevitt MC, Lynch J, et al. Patellar cartilage: T2 values and morphologic abnormalities at 3.0-T MR imaging in relation to physical activity in asymptomatic subjects from the osteoarthritis initiative. Radiology. 2010;254(2):509–20.PubMedCrossRef
22.
go back to reference Goldstein MG, Pinto BM, Marcus BH, Lynn H, Jette AM, Rakowski W, et al. Physician-based physical activity counseling for middle-aged and older adults: a randomized trial. Ann Behav Med. 1999;21(1):40–7.PubMedCrossRef Goldstein MG, Pinto BM, Marcus BH, Lynn H, Jette AM, Rakowski W, et al. Physician-based physical activity counseling for middle-aged and older adults: a randomized trial. Ann Behav Med. 1999;21(1):40–7.PubMedCrossRef
23.
go back to reference Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.PubMedCrossRef Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494–502.PubMedCrossRef
24.
go back to reference Peterfy CG, Schneider E, Nevitt M. The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee. Osteoarthritis Cartilage. 2008;16(12):1433–41.PubMedCrossRef Peterfy CG, Schneider E, Nevitt M. The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee. Osteoarthritis Cartilage. 2008;16(12):1433–41.PubMedCrossRef
25.
go back to reference McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Skeletal Radiol. 2001;30(6):312–5.PubMedCrossRef McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Skeletal Radiol. 2001;30(6):312–5.PubMedCrossRef
26.
go back to reference Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. AJR Am J Roentgenol. 2004;182(5):1283–7.PubMed Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. AJR Am J Roentgenol. 2004;182(5):1283–7.PubMed
27.
go back to reference Lawrance JA, Ostlere SJ, Dodd CA. MRI diagnosis of partial tears of the anterior cruciate ligament. Injury. 1996;27(3):153–5.PubMedCrossRef Lawrance JA, Ostlere SJ, Dodd CA. MRI diagnosis of partial tears of the anterior cruciate ligament. Injury. 1996;27(3):153–5.PubMedCrossRef
28.
go back to reference Van Dyck P, De Smet E, Veryser J, Lambrecht V, Gielen JL, Vanhoenacker FM, et al. Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):256–61.PubMedCrossRef Van Dyck P, De Smet E, Veryser J, Lambrecht V, Gielen JL, Vanhoenacker FM, et al. Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc. 2012;20(2):256–61.PubMedCrossRef
29.
go back to reference Bining J, Andrews G, Forster BB. The ABCs of the anterior cruciate ligament: a primer for magnetic resonance imaging assessment of the normal, injured and surgically repaired anterior cruciate ligament. Br J Sports Med. 2009;43(11):856–62.PubMedCrossRef Bining J, Andrews G, Forster BB. The ABCs of the anterior cruciate ligament: a primer for magnetic resonance imaging assessment of the normal, injured and surgically repaired anterior cruciate ligament. Br J Sports Med. 2009;43(11):856–62.PubMedCrossRef
30.
go back to reference Duryea J, Neumann G, Brem MH, Koh W, Noorbakhsh F, Jackson RD, et al. Novel fast semi-automated software to segment cartilage for knee MR acquisitions. Osteoarthritis Cartilage. 2007;15(5):487–92.PubMedCrossRef Duryea J, Neumann G, Brem MH, Koh W, Noorbakhsh F, Jackson RD, et al. Novel fast semi-automated software to segment cartilage for knee MR acquisitions. Osteoarthritis Cartilage. 2007;15(5):487–92.PubMedCrossRef
31.
go back to reference Link TM, Steinbach LS, Ghosh S, Ries M, Lu Y, Lane N, et al. Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology. 2003;226(2):373–81.PubMedCrossRef Link TM, Steinbach LS, Ghosh S, Ries M, Lu Y, Lane N, et al. Osteoarthritis: MR imaging findings in different stages of disease and correlation with clinical findings. Radiology. 2003;226(2):373–81.PubMedCrossRef
32.
go back to reference Hernigou P, Garabedian JM. Intercondylar notch width and the risk for anterior cruciate ligament rupture in the osteoarthritic knee: evaluation by plain radiography and CT scan. Knee. 2002;9(4):313–6.PubMedCrossRef Hernigou P, Garabedian JM. Intercondylar notch width and the risk for anterior cruciate ligament rupture in the osteoarthritic knee: evaluation by plain radiography and CT scan. Knee. 2002;9(4):313–6.PubMedCrossRef
33.
go back to reference Cushner FD, La Rosa DF, Vigorita VJ, Scuderi GR, Scott WN, Insall JN. A quantitative histologic comparison: ACL degeneration in the osteoarthritic knee. J Arthroplasty. 2003;18(6):687–92.PubMedCrossRef Cushner FD, La Rosa DF, Vigorita VJ, Scuderi GR, Scott WN, Insall JN. A quantitative histologic comparison: ACL degeneration in the osteoarthritic knee. J Arthroplasty. 2003;18(6):687–92.PubMedCrossRef
34.
go back to reference Almekinders LC, Pandarinath R, Rahusen FT. Knee stability following anterior cruciate ligament rupture and surgery. The contribution of irreducible tibial subluxation. J Bone Joint Surg Am. 2004;86-A(5):983–7.PubMed Almekinders LC, Pandarinath R, Rahusen FT. Knee stability following anterior cruciate ligament rupture and surgery. The contribution of irreducible tibial subluxation. J Bone Joint Surg Am. 2004;86-A(5):983–7.PubMed
35.
go back to reference Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N. Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med. 2003;31(1):75–9.PubMed Georgoulis AD, Papadonikolakis A, Papageorgiou CD, Mitsou A, Stergiou N. Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med. 2003;31(1):75–9.PubMed
36.
go back to reference Amin S, Guermazi A, Lavalley MP, Niu J, Clancy M, Hunter DJ, et al. Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis. Osteoarthritis Cartilage. 2008;16(8):897–902.PubMedCrossRef Amin S, Guermazi A, Lavalley MP, Niu J, Clancy M, Hunter DJ, et al. Complete anterior cruciate ligament tear and the risk for cartilage loss and progression of symptoms in men and women with knee osteoarthritis. Osteoarthritis Cartilage. 2008;16(8):897–902.PubMedCrossRef
37.
go back to reference Murrell GA, Maddali S, Horovitz L, Oakley SP, Warren RF. The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss. Am J Sports Med. 2001;29(1):9–14.PubMed Murrell GA, Maddali S, Horovitz L, Oakley SP, Warren RF. The effects of time course after anterior cruciate ligament injury in correlation with meniscal and cartilage loss. Am J Sports Med. 2001;29(1):9–14.PubMed
38.
go back to reference Bellabarba C, Bush-Joseph CA, Bach Jr BR. Patterns of meniscal injury in the anterior cruciate-deficient knee: a review of the literature. Am J Orthop (Belle Mead NJ). 1997;26(1):18–23. Bellabarba C, Bush-Joseph CA, Bach Jr BR. Patterns of meniscal injury in the anterior cruciate-deficient knee: a review of the literature. Am J Orthop (Belle Mead NJ). 1997;26(1):18–23.
39.
go back to reference Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL. Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J Orthop Res. 2000;18(1):109–15.PubMedCrossRef Allen CR, Wong EK, Livesay GA, Sakane M, Fu FH, Woo SL. Importance of the medial meniscus in the anterior cruciate ligament-deficient knee. J Orthop Res. 2000;18(1):109–15.PubMedCrossRef
40.
go back to reference David-Vaudey E, Ghosh S, Ries M, Majumdar S. T2 relaxation time measurements in osteoarthritis. Magn Reson Imaging. 2004;22(5):673–82.PubMedCrossRef David-Vaudey E, Ghosh S, Ries M, Majumdar S. T2 relaxation time measurements in osteoarthritis. Magn Reson Imaging. 2004;22(5):673–82.PubMedCrossRef
41.
go back to reference Van Dyck P, Vanhoenacker FM, Gielen JL, Dossche L, Van Gestel J, Wouters K, et al. Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears? Skeletal Radiol. 2011;40(6):701–7.PubMedCrossRef Van Dyck P, Vanhoenacker FM, Gielen JL, Dossche L, Van Gestel J, Wouters K, et al. Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears? Skeletal Radiol. 2011;40(6):701–7.PubMedCrossRef
Metadata
Title
Non-traumatic anterior cruciate ligament abnormalities and their relationship to osteoarthritis using morphological grading and cartilage T2 relaxation times: data from the Osteoarthritis Initiative (OAI)
Authors
Keegan K. Hovis
Hamza Alizai
Seng-Choe Tham
Richard B. Souza
Michael C. Nevitt
Charles E. McCulloch
Thomas M. Link
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 11/2012
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-012-1379-4

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