Development of MRI-defined structural tissue damage after anterior cruciate ligament injury over 5 Years: The KANON Study

Roemer F, Lohmander LS, Englund M, Guermazi A, Akesson A, Frobell R (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Radiology Radiological Society of North America (RSNA)

Book Volume: 299

Pages Range: 383-393

Journal Issue: 2

DOI: 10.1148/RADIOL.2021202954

Abstract

Background: MRI is used to evaluate structural joint changes after anterior cruciate ligament (ACL) injury, but no long-term data are available for comparing different treatment approaches. Purpose: To describe structural joint damage with MRI over a 5-year period in the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) study and to compare frequencies of such tissue damage for a nonsurgical versus a surgical treatment strategy. Materials and Methods: In this secondary analysis of a prospective trial (ISRCTN 84752559), 119 participants with an acute ACL injury were evaluated. Participants were enrolled from 2002 through 2006, the 2-year follow-up started in 2008, and the 5-year follow-up started in 2011. A 1.5-T MRI examination was performed at baseline and at 2- and 5-year follow-up. MRI scans were read according to a validated scoring instrument. Kruskal-Wallis tests were used to assess whether the frequencies of structural damage differed between the three as-treated groups. Results: Of 119 participants (mean age, 26 years ± 5 [standard deviation]), 91 men were evaluated. At 2- and 5-year follow-up, respectively, 13% (15 of 117) and 13% (15 of 115) of knees showed incident cartilage damage in the medial tibiofemoral joint, 11% (13 of 117) and 17% (20 of 115) of knees showed incident cartilage damage in the lateral tibiofemoral joint, and 4% (five of 117) and 8% (nine of 115) of knees showed incident cartilage damage in the patellofemoral joint. Osteophyte development was seen in 23% (27 of 117) and 29% (33 of 115) of knees in the medial tibiofemoral joint, in 36% (42 of 117) and 43% (49 of 115) of knees in the lateral tibiofemoral joint, and in 35% (41 of 117) and 37% (42 of 115) of knees in the patellofemoral joint. No major differences between the groups were found for incident or worsening cartilage damage, bone marrow lesions, and osteophytes at 2 or 5 years. The rehabilitation-alone group showed less Hoffa-synovitis at 2 (P = .02) and 5 (P = .008) years. Conclusion: Young adults with anterior cruciate ligament injury showed no major difference in frequency of structural tissue damage on MRI scans at 2 and 5 years regardless of treatment. However, the rehabilitation-alone group had less inflammation at 2 and 5 years.

Authors with CRIS profile

Frank Roemer Institute of Radiology

Involved external institutions

Lund University / Lunds universitet SE Sweden (SE) Boston Medical Center (BMC) US United States (USA) (US) Skåne University Hospital / Skånes universitetssjukhus SE Sweden (SE)

How to cite

APA:

Roemer, F., Lohmander, L.S., Englund, M., Guermazi, A., Akesson, A., & Frobell, R. (2021). Development of MRI-defined structural tissue damage after anterior cruciate ligament injury over 5 Years: The KANON Study. Radiology, 299(2), 383-393. https://doi.org/10.1148/RADIOL.2021202954

MLA:

Roemer, Frank, et al. "Development of MRI-defined structural tissue damage after anterior cruciate ligament injury over 5 Years: The KANON Study." Radiology 299.2 (2021): 383-393.

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