Knee Shape May Predict Who'll Benefit From ACL Surgery, Study Says07/19/13
FRIDAY, July 19 (HealthDay News) -- The shape of your knee could
influence whether you should have reconstruction surgery after
suffering an anterior cruciate ligament (ACL) tear, according to a
"This is the first study to show that after your ACL is ruptured, the changes in the mechanics of the knee can really be affected by the shape of the knee," Suzanne Maher, associate director of the biomechanics department at the Hospital for Special Surgery in New York City, said in a hospital news release.
"Previously, researchers had only conducted studies looking at whether a particular knee shape makes a person more likely to have an ACL injury, specifically in the athletic population," she noted.
Each year in the United States, about 200,000 people suffer an
ACL tear, and these injuries cost the health care system $1
billion. An ACL tear increases the risk of developing
osteoarthritis, joint degeneration and loss of cartilage that helps
stabilize the knee.
ACL reconstruction may prevent these problems, but not all
patients require this surgery. Some people have more stable knees
and won't develop further knee problems after an ACL tear. Skipping
surgery may be an option for patients who do not play sports that
involve pivoting, such as soccer or basketball. However, it's
difficult to identify patients who can avoid surgery without
developing further problems.
In this study, published online ahead of print in
Proceedings of the Institution of Mechanical Engineering,
researchers conducted experiments with nine knees from dead people
to examine how knee shape affects knee mechanics during walking
after an ACL tear.
The knees were outfitted with a sensor that measured the contact
stresses of a critical weight-bearing area on the top of the
shinbone called the tibial plateau. The knees were then mounted on
a machine that replicated the action of walking. The knees were
tested before and after the ACL was cut to mimic a tear.
The results showed that the shape of the knee can help determine
which patients are more likely to develop further cartilage damage
in the front and the back of the knee after an ACL tear. This means
that X-rays may help doctors identify patients who do not require
"This is a limited study because these are dead knees, we are only looking at walking, it is only a small sample size, we have focused on the inside of the knee, etc., but it provides a glint of information about how the knee functions after an ACL rupture," Maher pointed out in the news release. "Even though this is a lab-based study, it suggests that the shape of a person's knee may be ultimately used as some guidance as to whether certain patients should have their ACL replaced or repaired versus other patients."
The U.S. National Library of Medicine has more about
anterior cruciate ligament injury.
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