Loading during Midstance of Gait Is Associated with Magnetic Resonance Imaging of Cartilage Composition Following Anterior Cruciate Ligament Reconstruction

Objective. A complex association exists between aberrant gait biomechanics and posttraumatic knee osteoarthritis (PTOA) development. Previous research has primarily focused on the link between peak loading during the loading phase of stance and joint tissue changes following anterior cruciate ligament reconstruction (ACLR). However, the associations between loading and cartilage composition at other portions of stance, including midstance and late stance, is unclear. The objective of this study was to explore associations between vertical ground reaction force (vGRF) at each 1% increment of stance phase and tibiofemoral articular cartilage magnetic resonance imaging (MRI) T1 rho relaxation times following ACLR. Design. Twenty-three individuals (47.82% female, 22.1 +/- 4.1 years old) with unilateral ACLR participated in a gait assessment and T1 rho MRI collection at 12.25 0.61 months post-ACLR. T1 rho relaxation times were calculated for the articular cartilage of the weightbearing medial and lateral femoral (MFC, LFC) and tibial (MTC, LTC) condyles. Separate bivariate, Pearson product moment correlation coefficients (r) were used to estimate strength of associations between T1 rho MRI relaxation times in the medial and lateral tibiofemoral articular cartilage with vGRF across the entire stance phase. Results. Greater vGRF during midstance (46%-56% of stance phase) was associated with greater T1 rho MRI relaxation times in the MFC (r ranging between 0.43 and 0.46). Conclusions. Biomechanical gait profiles that include greater vGRF during midstance are associated with MRI estimates of lesser proteoglycan density in the MFC. Inability to unload the ACLR limb during midstance may be linked to joint tissue changes associated with PTOA development.

Automated summary

This study aimed to explore the associations between different vertical ground reaction forces (vGRF) at each stage of gait post anterior cruciate ligament reconstruction (ACLR) and tibiofemoral articular cartilage magnetic resonance imaging (MRI) T1 rho relaxation times. The results showed that greater vGRF during midstance (46%-56% of stance phase) was associated with lesser proteoglycan density in the medial femoral condyle.