Thesis
Utilizing weight bearing CT to evaluate PTOA risk after ACL Reconstruction
University of Iowa
Master of Science (MS), University of Iowa
Spring 2024
DOI: 10.25820/etd.007374
Abstract
The risk of post-traumatic osteoarthritis (PTOA) and associated joint degeneration afterACL injury is high, with roughly 50% of individuals experiencing symptoms 10 to 20 years after
injury. Efforts to mitigate PTOA risk after ACL injury have been stalled by the lack of sensitive,
specific, and affordable early imaging markers. The current clinical gold standard Kellgren-
Lawrence (KL) grading scale that utilizes frontal view radiographs is limited due to its reliance
on 2D projection of 3D structures. The introduction of low-dose weight bearing computed
tomography (WBCT) has made the imaging of joints in functionally loaded positions readily
available, allowing for 3D analysis of joint space narrowing in load-bearing regions. WBCT
shows promise for early PTOA detection enhancing earlier intervention.
The objective of this study is to utilize a previously developed fully automated method to
measure tibiofemoral 3D pose and joint space width (JSW) from WBCT to assess PTOA risk
following ACL reconstruction (ACLR). Bilateral WBCT scans were acquired in a semi-flexed
(~20°) and fully extended scan pose for subjects at 3-months and 1-year after ACLR. 3D JSW
was evaluated between scan poses and timepoints for the ACLR and intact contralateral knees. A
semi-automated method to regionally assess JSW values was utilized to evaluate knee kinematics
and the relationship of regional JSW values over the 9-month scan period. Further, regions of
narrow JSW were used to nominally define the joint center of contact (CoC) in each tibiofemoral
compartment. The CoC was then evaluated between scan poses and time-points to evaluate the
influence of ACLR on the screw-home mechanism (SHM) in the knee at terminal extension. The
establishing of new WBCT-based 3D imaging markers that reliably and affordably assess PTOA
risk and can detect degenerative joint changes earlier can facilitate more effective interventions.
Details
- Title: Subtitle
- Utilizing weight bearing CT to evaluate PTOA risk after ACL Reconstruction
- Creators
- Tyce Chandler Marquez
- Contributors
- Donald D Anderson (Advisor)Brian R Wolf (Committee Member)Colleen L Bringman (Committee Member)Edward Sander (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Biomedical Engineering
- Date degree season
- Spring 2024
- DOI
- 10.25820/etd.007374
- Publisher
- University of Iowa
- Number of pages
- x, 62 pages
- Copyright
- Copyright 2024 Tyce Chandler Marquez
- Grant note
- I also want to thank the Arthritis Foundation for the funding for this project. (ii)
- Language
- English
- Date submitted
- 04/16/2024
- Description illustrations
- illustrations (some color)
- Description bibliographic
- Includes bibliographical references (page 48-50).
- Public Abstract (ETD)
Knee osteoarthritis (OA) is a common cause of pain, affecting millions in the United States alone. Serious joint injuries, such as an ACL tear, can cause a type of OA called posttraumatic osteoarthritis (PTOA). Approximately 50% of individuals who tear their ACL experience PTOA 10 to 20 years following injury. Many young and active individuals tear their ACL yearly, leading to many young people at risk for PTOA that results in pain and disability. Medical imaging to detect early PTOA risk has lacked quality and affordability. A new imaging technology, weight bearing CT (WBCT), has helped image joints in functionally loaded positions. WBCT shows promise to detect PTOA risk earlier, leading to earlier opportunities for intervention.
This study used a recently developed automated method to measure PTOA risk markers from WBCT scans. Study subjects were monitored at 3-months and 1-year after ACL surgery, with WBCT scans acquired in a flexed and extended knee position. The PTOA risk markers were evaluated for both the ACL surgery and non-injured knees for comparison. With WBCT, data were available and PTOA risk markers were monitored in relation to joint space width and bone positions. New markers from WBCT imaging can help create a quicker response to step in and limit the progression of the PTOA symptoms.
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Craniofacial Anomalies Research Center
- Record Identifier
- 9984647455002771
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