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First published on February 8, 2005, doi:10.1177/0363546504268040
This version was published on March 1, 2005
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Right arrow Injury
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The American Journal of Sports Medicine 33:408-414 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

Arthroscopic Cartilage Indentation and Cartilage Lesions of Anterior Cruciate Ligament–Deficient Knees

Anna I. Vasara, MD*,{dagger}, Jukka S. Jurvelin, PhD{ddagger}, Lars Peterson, MD, PhD§ and Ilkka Kiviranta, MD, PhD||

From the {dagger} Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland, the {ddagger} Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, and Department of Applied Physics, University of Kuopio, Kuopio, Finland, the § Department of Orthopaedics, Göteborg University, Gothenburg, Sweden, and the || Department of Surgery, Jyväskylä Central Hospital, Jyväskylä, Finland

* Address correspondence to Anna I. Vasara, MD, Vilkenintie 16 A, 00640 Helsinki, Finland (e-mail: anna.vasara{at}fimnet.fi).

Background: The anterior cruciate ligament–deficient knee is prone to osteoarthritis and meniscus lesions. Very little, however, is known about the biomechanical properties of articular cartilage in anterior cruciate ligament–deficient knees.

Purpose: To evaluate biomechanical and macroscopical cartilage changes in the knee joint with respect to the time after anterior cruciate ligament rupture.

Hypothesis: Chronic anterior cruciate ligament deficiency induces cartilage softening.

Study Design: Cross-sectional study; Level of evidence, 3.

Methods: Cartilage stiffness of 50 patients undergoing anterior cruciate ligament reconstructive surgery because of symptomatic knee instability after chronic anterior cruciate ligament rupture was measured with an arthroscopic indenter device, and the number and size of cartilage lesions were evaluated.

Results: The cartilage stiffness did not correlate with time from trauma to surgery (r = 0.002, P = .99), but the number of cartilage lesions in the knee increased when the time from the initial trauma to reconstructive surgery increased (r = 0.356, P = .011). Indentation values measured on healthy-looking cartilage on damaged joint surfaces were lower than the values measured on healthy joint surfaces (P < .01 on lateral femoral condyle and on tibial plateaus).

Conclusions: The number of cartilage lesions increases with increased time after initial trauma. The arthroscopic indenter device is able to detect cartilage softening as the early mechanical sign of degradation not yet visible to the eye.

Key Words: cartilage stiffness • anterior cruciate ligament (ACL) deficiency • cartilage indentation • cartilage lesions




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