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Stress on the posteromedial region of the proximal tibia increased over time after anterior cruciate ligament injury

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Title: Stress on the posteromedial region of the proximal tibia increased over time after anterior cruciate ligament injury
Authors: Miura, Soya Browse this author
Iwasaki, Koji Browse this author →KAKEN DB
Kondo, Eiji Browse this author
Endo, Kaori Browse this author
Matsubara, Shinji Browse this author
Matsuoka, Masatake Browse this author
Onodera, Tomohiro Browse this author
Iwasaki, Norimasa Browse this author →KAKEN DB
Keywords: Anterior cruciate ligament
Stress distribution
Computed tomography-osteoabsorptiometry
Issue Date: 1-May-2022
Publisher: Springer
Journal Title: Knee surgery sports traumatology arthroscopy
Volume: 30
Issue: 5
Start Page: 1744
End Page: 1751
Publisher DOI: 10.1007/s00167-021-06731-4
Abstract: Purpose Anterior cruciate ligament (ACL) injury induces anterior and rotatory instability of the knee. However, the effect of this instability on the stress distribution in the knee joint in living participants is not clear. The aim of this study was to compare the distribution pattern of subchondral bone density across the proximal tibia in the knees with and without ACL injury, and to investigate the correlation between the distribution patterns of the subchondral bone density and the duration of ACL-deficiency. Methods Radiographic and computed tomography (CT) data pertaining to 20 patients with unilateral ACL injury without combined injury (ACL-deficient group) and 19 nontraumatic subjects (control group) were collected retrospectively. Subchondral bone density of the proximal tibia was assessed using CT-osteoabsorptiometry. Both the medial and lateral compartments of the proximal tibia were divided into three subregions of equal width in the sagittal direction. The percentage of high subchondral bone density areas (HDA%) in each subregion was quantitatively analyzed. Results HDA% of the posteromedial region was significantly higher in the ACL-deficient group (mean: 21.6%) than in the control group (14.7%) (p = 0.002). In contrast, HDA% of the anteromedial region was significantly lower in the ACL-deficient group (9.4%) than in the control group (15.3%) (p = 0.048). The logarithm of the time elapsed from ACL injury to CT examination showed a significant correlation with HDA% in the posteromedial region (p = 0.032). Conclusions Subchondral bone density in the posteromedial region significantly increased after ACL injury and correlated with the duration of ACL-deficiency in semi-log manner in meniscus intact knees. The increase in stress on the posteromedial region after ACL injury, which induces a change in the subchondral bone density, justifies early ACL reconstruction after ACL injury.
Rights: This is a post-peer-review, pre-copyedit version of an article published in Knee Surgery, Sports Traumatology, Arthroscopy. The final authenticated version is available online at:
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 岩崎 浩司

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