Knee cartilage T2 relaxation times 3 months after ACL reconstruction are associated with knee gait variables linked to knee osteoarthritis

Osteoarthritis development after ACL reconstruction (ACLR) is not well understood. Investigators have examined associations between knee biomechanical alterations and quantitative MRI (qMRI) variables, reflective of cartilage health, 12–60 months following ACLR; however, none have done so early after surgery. As part of an exploratory study, 45 individuals (age, 23 ± 7 years) underwent motion analysis during walking and qMRI 3 months after ACLR. For each limb, peak knee adduction moment (pKAM) and peak knee flexion moment (pKFM) were determined using inverse dynamics and peak medial compartment force was calculated using a neuromusculoskeletal model. T₂ relaxation times in the medial compartment and linear regressions were used to determine the associations between gait variables and deep and superficial cartilage T₂ relaxation times in six regions. pKAM was positively associated with deep layer T₂ relaxation times within the femoral central and posterior regions when examined in the involved limb and from an interlimb difference perspective (involved limb – uninvolved limb). After adjusting for age, the association between interlimb difference of pKAM and interlimb difference of deep layer T₂ relaxation times in the tibial central region became significant (p = .043). Interlimb difference of pKFM was negatively associated with interlimb difference of deep layer T₂ relaxation times within the femoral central and posterior regions. These associations suggest that degenerative pathways leading to osteoarthritis may be detectable as early as 3 months after reconstruction. Preventative therapeutic techniques may need to be employed early in the rehabilitation process to prevent cartilage degradation.