Alterations in Patellofemoral Kinematics Following Anterior Cruciate Ligament Deficient and Reconstruction
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香港中文大學研究人員

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摘要Objective
The prevalence of Knee osteoarthritis (including tibiofemoral and patellofemoral joint) after ACL reconstruction is high. This study is to quantificationally determine the relationship between biomechanics following anterior cruciate ligament (ACL) rupture and reconstruction and the development of patellofemoral OA after ACL deficient and reconstruction.

Methods
Eighteen fresh-frozen human cadaveric knees from donors will be loaded using a robotic manipulator to simulate knee joint motion from extension to high flexion. Motions will be recorded with the ACL intact (group 1, 6 knees), with the ACL sectioned (group 2, 6 knees), and with ACL reconstruction (group 3, 6 knees). Patellofemoral kinematics, knee abduction moment, contact pressure and area will be evaluated in the whole procedure from extension to high flexion (150°). Sensors will be used to measure contact pressure and contact area between femur and patella. Flexion angles will be divided into three levels: lower flexion angel:0°~30°; Middle flexion angle: 31°~90°; higher flexion angle: 91°~150°. We compare the difference of patellofemoral kinematics, knee abduction moment, contact pressure/area in different flexion levels in the three groups that have different ACL status. Repeated measures ANOVA will be used to analyze the difference among groups.

Potential implication
The patellofemoral compartment should be included as part routine radiographic examinations following ACL reconstruction. Clinicians should consider the patellofemoral joint during postoperative rehabilitation in an attempt to address long-term symptoms and degenerative joint disease. Particular clinical attention should be paid to optimize patellofemoral function in individuals with patellofemoral chondral lesions observed at the time of ACLR.

Reference
[1] Claes S, Hermie L, Verdonk R, Bellemans J, Verdonk P. Is osteoarthritis an inevitable consequence of anterior cruciate ligament reconstruction? A meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2013;21(9):1967–1976.
[2] Van de Velde SK, Gill TJ, DeFrate LE, et al. The effect of anterior cruciate ligament deficiency and reconstruction on the patellofemoral joint. Am J Sports Med 2008;36:1150–9.
[3] Van Meer BL, Meuffels DE, van Eijsden WA, et al. Which determinants predict tibiofemoral and patellofemoral osteoarthritis after anterior cruciate ligament injury? A systematic review. Br J Sports Med. 201549(15):975-83.
[4] Culvenor A G, Lai C C H, Gabbe B J, et al. Patellofemoral osteoarthritis is prevalent and associated with worse symptoms and function after hamstring tendon autograft ACL reconstruction[J]. British journal of sports medicine, 2014, 48(6): 435-439.
著者HUANG W.H., MOK K.M., CHAN Y.C., FUNG P.W., FU S.C., YUNG P.S.H., CHAN K.M.
會議名稱5th HKASMSS Student Conference on Sports Medicine, Rehabilitation and Exercise Science 2016
會議開始日26.11.2016
會議完結日26.11.2016
會議地點Hong Kong, China
會議國家/地區香港
出版年份2017
語言美式英語

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