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Patellofemoral MRI Alterations Following Single Bundle ACL Reconstruction with Hamstring Autografts Are Associated with Quadriceps Femoris Atrophy

Current Medical Science volume 39, pages 1029–1036 (2019)Cite this article

Summary

High incidence of patellofemoral pain and patellofemoral joint osteoarthritis was found following anterior cruciate ligament (ACL) reconstruction. The unstability of patellofemoral joint might be an important contribution factor. This study was designed to define the relationship between the unstability of patellofemoral joint and quadriceps femoris atrophy. Twenty patients underwent MRI scan before ACL reconstruction and every two weeks after surgery, until 12 weeks. The merchant’s patellar congruence angle, lateral inclination angle, and quadriceps femoris muscle cross-sectional area were measured and the relationship between the changes of angles and the ratio of quadriceps femoris atrophy was studied by multiple regression analysis. Significant quadriceps femoris atrophy was observed after ACL reconstruction during the follow-up period of 12 weeks. The merchant’s patellar congruence angle and lateral inclination angle significantly changed after surgery. The alterations of the merchant’s patellar congruence angle were significantly correlated with the atrophy ratio of vastus medialis (coefficient=−15.76) and vastus lateralis (coefficient=8.35) during the follow-up period of 12 weeks. The alterations of lateral inclination angle were significantly correlated with the atrophy ratio of vastus medialis (coefficient=20.62), vastus lateralis (coefficient=−11.38) and rectus femoris (coefficient=−0.469) during the follow-up period 12 weeks. To sum up, ACL reconstruction can alleviate the dysfunction of patellofemoral joint to a certain extent. But, the unbalanced atrophy of quadriceps femoris once again destroyed the stability of patellofemoral joint following the operation, which might be one cause of patellofemoral joint pain and early onset of osteoarthritis after ACL reconstruction. So, rehabilitation training that focuses on quadriceps femoris especially the vastus medialis shortly following operation is suggested.

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Acknowledgments

The authors acknowledge the devoted help of Fei PENG and Jian-pin LI (Department of Orthopedics, Renmin Hospital of Wuhan University) in the measurement.

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Affiliations

  1. Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, 430060, China

    Wei-song Cai, Hao-huan Li, Si-qi Zhou, Yu-biao Zhang & Guang-tao Han

  2. Department of Orthopedics, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan

    Shin-ichi Konno & Hironori Numazaki

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  1. Wei-song Cai
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  2. Hao-huan Li
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  4. Hironori Numazaki
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  5. Si-qi Zhou
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  7. Guang-tao Han
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Correspondence to Hao-huan Li.

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Conflict of Interest Statement

The authors declare that they have no conflict of interest.

This study was supported by the National Natural Science Foundation of China (No. 81171760).

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Cai, Ws., Li, Hh., Konno, Si. et al. Patellofemoral MRI Alterations Following Single Bundle ACL Reconstruction with Hamstring Autografts Are Associated with Quadriceps Femoris Atrophy. CURR MED SCI 39, 1029–1036 (2019). https://doi.org/10.1007/s11596-019-2138-8

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  • DOI: https://doi.org/10.1007/s11596-019-2138-8

Key words

  • patellofemoral joint osteoarthritis
  • quadriceps femoris atrophy
  • joint instability
  • anterior cruciate ligament reconstruction