Varus alignment of the hip and knee 2 years after anterior cruciate ligament injury is associated with medial tibiofemoral osteoarthritis 3 years later. Nilsson, H., Englund, M., Frobell, R., Lohmander, L. S., Struglics, A., & Swärd, P. Journal of Experimental Orthopaedics, 12(1):e70143, January, 2025. doi abstract bibtex PURPOSE: To investigate if hip and knee alignment assessed 2 years after anterior cruciate ligament (ACL) injury is associated with compartment-specific radiographic knee osteoarthritis (OA) 3 years later. METHODS: An exploratory analysis was conducted in the knee ACL, nonsurgical versus surgical treatment (KANON) trial (ISRCTN84752559); 115 subjects with acute ACL injury were assessed at the 2-year follow-up; full-limb images of the injured leg were acquired, and the neck-shaft angle (NSA) and hip-knee-ankle angle (HKA) were measured. At the 5-year follow-up, weight-bearing tibiofemoral and patellofemoral radiographs were obtained. Radiographs were graded according to the OA Research Society International Atlas and Radiographic OA was defined as approximating Kellgren & Lawrence grade 2 or worse. Analysis of covariance adjusting for sex, age, body mass index, randomization and partial meniscectomy recorded at the 2-year follow-up was performed. RESULTS: In patients who had developed medial tibiofemoral OA at the 5-year follow-up, the NSA and the HKA at the 2-year follow-up were smaller (NSA, mean difference = -4.6° [95% confidence interval \CI\ -7.9° to -1.1°]; HKA, mean difference = -2.3° [95% CI -4.2° to -0.4°]). No association was observed between the NSA or HKA at the 2-year follow-up and lateral tibiofemoral OA, nor patellofemoral OA at the 5-year follow-up. CONCLUSION: A smaller NSA and HKA angle of the ACL injured leg (i.e., more varus hip and varus knee alignment) 2 years after the injury was associated with medial tibiofemoral radiographic OA 3 years later. LEVEL OF EVIDENCE: Level II exploratory post hoc analysis of an RCT.
@article{nilsson_varus_2025,
title = {Varus alignment of the hip and knee 2 years after anterior cruciate ligament injury is associated with medial tibiofemoral osteoarthritis 3 years later},
volume = {12},
issn = {2197-1153},
doi = {10.1002/jeo2.70143},
abstract = {PURPOSE: To investigate if hip and knee alignment assessed 2 years after anterior cruciate ligament (ACL) injury is associated with compartment-specific radiographic knee osteoarthritis (OA) 3 years later.
METHODS: An exploratory analysis was conducted in the knee ACL, nonsurgical versus surgical treatment (KANON) trial (ISRCTN84752559); 115 subjects with acute ACL injury were assessed at the 2-year follow-up; full-limb images of the injured leg were acquired, and the neck-shaft angle (NSA) and hip-knee-ankle angle (HKA) were measured. At the 5-year follow-up, weight-bearing tibiofemoral and patellofemoral radiographs were obtained. Radiographs were graded according to the OA Research Society International Atlas and Radiographic OA was defined as approximating Kellgren \& Lawrence grade 2 or worse. Analysis of covariance adjusting for sex, age, body mass index, randomization and partial meniscectomy recorded at the 2-year follow-up was performed.
RESULTS: In patients who had developed medial tibiofemoral OA at the 5-year follow-up, the NSA and the HKA at the 2-year follow-up were smaller (NSA, mean difference = -4.6° [95\% confidence interval \{CI\} -7.9° to -1.1°]; HKA, mean difference = -2.3° [95\% CI -4.2° to -0.4°]). No association was observed between the NSA or HKA at the 2-year follow-up and lateral tibiofemoral OA, nor patellofemoral OA at the 5-year follow-up.
CONCLUSION: A smaller NSA and HKA angle of the ACL injured leg (i.e., more varus hip and varus knee alignment) 2 years after the injury was associated with medial tibiofemoral radiographic OA 3 years later.
LEVEL OF EVIDENCE: Level II exploratory post hoc analysis of an RCT.},
language = {eng},
number = {1},
journal = {Journal of Experimental Orthopaedics},
author = {Nilsson, Henrik and Englund, Martin and Frobell, Richard and Lohmander, L. Stefan and Struglics, André and Swärd, Per},
month = jan,
year = {2025},
keywords = {alignment, anterior cruciate ligament, hip knee ankle angle, neck‐shaft angle, osteoarthritis},
pages = {e70143},
}
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{"_id":"dwF8eBjN6zXT6PG5H","bibbaseid":"nilsson-englund-frobell-lohmander-struglics-swrd-varusalignmentofthehipandknee2yearsafteranteriorcruciateligamentinjuryisassociatedwithmedialtibiofemoralosteoarthritis3yearslater-2025","author_short":["Nilsson, H.","Englund, M.","Frobell, R.","Lohmander, L. S.","Struglics, A.","Swärd, P."],"bibdata":{"bibtype":"article","type":"article","title":"Varus alignment of the hip and knee 2 years after anterior cruciate ligament injury is associated with medial tibiofemoral osteoarthritis 3 years later","volume":"12","issn":"2197-1153","doi":"10.1002/jeo2.70143","abstract":"PURPOSE: To investigate if hip and knee alignment assessed 2 years after anterior cruciate ligament (ACL) injury is associated with compartment-specific radiographic knee osteoarthritis (OA) 3 years later. METHODS: An exploratory analysis was conducted in the knee ACL, nonsurgical versus surgical treatment (KANON) trial (ISRCTN84752559); 115 subjects with acute ACL injury were assessed at the 2-year follow-up; full-limb images of the injured leg were acquired, and the neck-shaft angle (NSA) and hip-knee-ankle angle (HKA) were measured. At the 5-year follow-up, weight-bearing tibiofemoral and patellofemoral radiographs were obtained. Radiographs were graded according to the OA Research Society International Atlas and Radiographic OA was defined as approximating Kellgren & Lawrence grade 2 or worse. Analysis of covariance adjusting for sex, age, body mass index, randomization and partial meniscectomy recorded at the 2-year follow-up was performed. RESULTS: In patients who had developed medial tibiofemoral OA at the 5-year follow-up, the NSA and the HKA at the 2-year follow-up were smaller (NSA, mean difference = -4.6° [95% confidence interval \\CI\\ -7.9° to -1.1°]; HKA, mean difference = -2.3° [95% CI -4.2° to -0.4°]). No association was observed between the NSA or HKA at the 2-year follow-up and lateral tibiofemoral OA, nor patellofemoral OA at the 5-year follow-up. CONCLUSION: A smaller NSA and HKA angle of the ACL injured leg (i.e., more varus hip and varus knee alignment) 2 years after the injury was associated with medial tibiofemoral radiographic OA 3 years later. LEVEL OF EVIDENCE: Level II exploratory post hoc analysis of an RCT.","language":"eng","number":"1","journal":"Journal of Experimental Orthopaedics","author":[{"propositions":[],"lastnames":["Nilsson"],"firstnames":["Henrik"],"suffixes":[]},{"propositions":[],"lastnames":["Englund"],"firstnames":["Martin"],"suffixes":[]},{"propositions":[],"lastnames":["Frobell"],"firstnames":["Richard"],"suffixes":[]},{"propositions":[],"lastnames":["Lohmander"],"firstnames":["L.","Stefan"],"suffixes":[]},{"propositions":[],"lastnames":["Struglics"],"firstnames":["André"],"suffixes":[]},{"propositions":[],"lastnames":["Swärd"],"firstnames":["Per"],"suffixes":[]}],"month":"January","year":"2025","keywords":"alignment, anterior cruciate ligament, hip knee ankle angle, neck‐shaft angle, osteoarthritis","pages":"e70143","bibtex":"@article{nilsson_varus_2025,\n\ttitle = {Varus alignment of the hip and knee 2 years after anterior cruciate ligament injury is associated with medial tibiofemoral osteoarthritis 3 years later},\n\tvolume = {12},\n\tissn = {2197-1153},\n\tdoi = {10.1002/jeo2.70143},\n\tabstract = {PURPOSE: To investigate if hip and knee alignment assessed 2 years after anterior cruciate ligament (ACL) injury is associated with compartment-specific radiographic knee osteoarthritis (OA) 3 years later.\nMETHODS: An exploratory analysis was conducted in the knee ACL, nonsurgical versus surgical treatment (KANON) trial (ISRCTN84752559); 115 subjects with acute ACL injury were assessed at the 2-year follow-up; full-limb images of the injured leg were acquired, and the neck-shaft angle (NSA) and hip-knee-ankle angle (HKA) were measured. At the 5-year follow-up, weight-bearing tibiofemoral and patellofemoral radiographs were obtained. Radiographs were graded according to the OA Research Society International Atlas and Radiographic OA was defined as approximating Kellgren \\& Lawrence grade 2 or worse. Analysis of covariance adjusting for sex, age, body mass index, randomization and partial meniscectomy recorded at the 2-year follow-up was performed.\nRESULTS: In patients who had developed medial tibiofemoral OA at the 5-year follow-up, the NSA and the HKA at the 2-year follow-up were smaller (NSA, mean difference = -4.6° [95\\% confidence interval \\{CI\\} -7.9° to -1.1°]; HKA, mean difference = -2.3° [95\\% CI -4.2° to -0.4°]). No association was observed between the NSA or HKA at the 2-year follow-up and lateral tibiofemoral OA, nor patellofemoral OA at the 5-year follow-up.\nCONCLUSION: A smaller NSA and HKA angle of the ACL injured leg (i.e., more varus hip and varus knee alignment) 2 years after the injury was associated with medial tibiofemoral radiographic OA 3 years later.\nLEVEL OF EVIDENCE: Level II exploratory post hoc analysis of an RCT.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Journal of Experimental Orthopaedics},\n\tauthor = {Nilsson, Henrik and Englund, Martin and Frobell, Richard and Lohmander, L. Stefan and Struglics, André and Swärd, Per},\n\tmonth = jan,\n\tyear = {2025},\n\tkeywords = {alignment, anterior cruciate ligament, hip knee ankle angle, neck‐shaft angle, osteoarthritis},\n\tpages = {e70143},\n}\n\n","author_short":["Nilsson, H.","Englund, M.","Frobell, R.","Lohmander, L. 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