Development of MRI-defined structural tissue damage after anterior cruciate ligament injury over 5 years: The KANON study. Roemer, F. W., Lohmander, L. S., Englund, M., Guermazi, A., Åkesson, A., & Frobell, R. Radiology, 299(2):383–393, May, 2021. Publisher: Radiological Society of North America
Development of MRI-defined structural tissue damage after anterior cruciate ligament injury over 5 years: The KANON study [link]Paper  doi  abstract   bibtex   
BackgroundMRI 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.PurposeTo 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 MethodsIn 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.ResultsOf 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.ConclusionYoung 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.© RSNA, 2021Online supplemental material is available for this article.See also the editorial by Andreisek in this issue.
@article{roemer_development_2021,
	title = {Development of {MRI}-defined structural tissue damage after anterior cruciate ligament injury over 5 years: {The} {KANON} study},
	volume = {299},
	issn = {0033-8419},
	shorttitle = {Development of {MRI}-defined {Structural} {Tissue} {Damage} after {Anterior}                     {Cruciate} {Ligament} {Injury} over 5 {Years}},
	url = {https://pubs.rsna.org/doi/10.1148/radiol.2021202954},
	doi = {10.1148/radiol.2021202954},
	abstract = {BackgroundMRI 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.PurposeTo 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 MethodsIn 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.ResultsOf 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.ConclusionYoung 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.© RSNA, 2021Online supplemental material is available for this                                     article.See also the editorial by Andreisek in this issue.},
	number = {2},
	urldate = {2021-03-29},
	journal = {Radiology},
	author = {Roemer, Frank                             W. and Lohmander, L.                             Stefan and Englund, Martin and Guermazi, Ali and Åkesson, Anna and Frobell, Richard},
	month = may,
	year = {2021},
	note = {Publisher: Radiological Society of North America},
	pages = {383--393},
}

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