Image analysis of bone density following anterior cruciate ligament injury

C Findlay, SS Jameson, Stephen Marshall, B. Walker, C. Walker, R.M.D. Meek, A. Nicol

Research output: Contribution to journalConference Contribution

Abstract

Following an anterior cruciate ligament (ACL) injury, the affected knee is known to experience bone loss and is at significant risk of becoming osteoporotic. Surgical reconstruction is performed to attempt to restore the function of the knee and theoretically restore this bone density loss. Cross-sectional analysis of the proximal tibia using peripheral quantitative computed tomography (pQCT) enables localised analysis of bone mineral density (BMD) changes. The aim of this study was to establish the pattern of bone density changes in the tibia pre- and post- ACL reconstruction using pQCT image analysis.

Eight patients who underwent ACL reconstruction were included. A cross sectional analysis of the proximal tibia was performed using a pQCT scanner pre-operatively and one to two years post-operatively on both the injured and contralateral (control) knee. The proximal two and three percent slices [S2 and S3] along the tibia were acquired. These were exported to Matlab(tm) and automated segmentation was performed to remove the tibia from its surrounding structures. Cross correlation was applied to co-register pairs of images and patterns of change in BMD were mapped using a t-test (p<0.05). Connected components of pixels with significant change in BMD were created and used to assess the impact of ACL injury & reconstruction on the proximal tibial BMD.

Prior to surgical ACL reconstruction, the BMD in the injured leg was significantly reduced relative to the control leg [S2: p=0.002, S3: p=0.002]. Post surgery, the proximal tibial BMD did not change in either leg [Control S2: p=0.102, S3: p=0.181; Injured S2: p=0.093, S3: p=0.439]. The post surgical images demonstrated patterns of increasing BMD surrounding the tunnel in the form of compact bone.

A significant reduction in proximal tibial BMD was observed in the ACL injured legs relative to control legs. The pattern of pre-operative bone loss was generally observed to be global across the entire slice. No change in BMD was observed following ACL reconstruction, in either injured or control leg. These results indicate that proximal tibial BMD is reduced and does not change after ACL reconstruction.
LanguageEnglish
Journal Journal of Bone and Joint Surgery
Volume94-B
Issue numbersupp XVIII 31
Publication statusPublished - 2010
EventBioengineering10 - Nottingham, United Kingdom
Duration: 15 Sep 201016 Sep 2010

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Bone Density
Anterior Cruciate Ligament Reconstruction
Leg
Tibia
Knee
Anterior Cruciate Ligament Injuries
Cross-Sectional Studies
Tomography
X-Ray Computed Tomography Scanners
Bone and Bones
Anterior Cruciate Ligament

Keywords

  • image analysis
  • bone density
  • anterior cruciate ligament injury
  • bone loss
  • osteoporotic

Cite this

Findlay, C., Jameson, SS., Marshall, S., Walker, B., Walker, C., Meek, R. M. D., & Nicol, A. (2010). Image analysis of bone density following anterior cruciate ligament injury. Journal of Bone and Joint Surgery, 94-B(supp XVIII 31).
Findlay, C ; Jameson, SS ; Marshall, Stephen ; Walker, B. ; Walker, C. ; Meek, R.M.D. ; Nicol, A. / Image analysis of bone density following anterior cruciate ligament injury. In: Journal of Bone and Joint Surgery. 2010 ; Vol. 94-B, No. supp XVIII 31.
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Findlay, C, Jameson, SS, Marshall, S, Walker, B, Walker, C, Meek, RMD & Nicol, A 2010, 'Image analysis of bone density following anterior cruciate ligament injury' Journal of Bone and Joint Surgery, vol. 94-B, no. supp XVIII 31.

Image analysis of bone density following anterior cruciate ligament injury. / Findlay, C; Jameson, SS; Marshall, Stephen; Walker, B.; Walker, C.; Meek, R.M.D.; Nicol, A.

In: Journal of Bone and Joint Surgery, Vol. 94-B, No. supp XVIII 31, 2010.

Research output: Contribution to journalConference Contribution

TY - JOUR

T1 - Image analysis of bone density following anterior cruciate ligament injury

AU - Findlay, C

AU - Jameson, SS

AU - Marshall, Stephen

AU - Walker, B.

AU - Walker, C.

AU - Meek, R.M.D.

AU - Nicol, A.

PY - 2010

Y1 - 2010

N2 - Following an anterior cruciate ligament (ACL) injury, the affected knee is known to experience bone loss and is at significant risk of becoming osteoporotic. Surgical reconstruction is performed to attempt to restore the function of the knee and theoretically restore this bone density loss. Cross-sectional analysis of the proximal tibia using peripheral quantitative computed tomography (pQCT) enables localised analysis of bone mineral density (BMD) changes. The aim of this study was to establish the pattern of bone density changes in the tibia pre- and post- ACL reconstruction using pQCT image analysis. Eight patients who underwent ACL reconstruction were included. A cross sectional analysis of the proximal tibia was performed using a pQCT scanner pre-operatively and one to two years post-operatively on both the injured and contralateral (control) knee. The proximal two and three percent slices [S2 and S3] along the tibia were acquired. These were exported to Matlab(tm) and automated segmentation was performed to remove the tibia from its surrounding structures. Cross correlation was applied to co-register pairs of images and patterns of change in BMD were mapped using a t-test (p<0.05). Connected components of pixels with significant change in BMD were created and used to assess the impact of ACL injury & reconstruction on the proximal tibial BMD. Prior to surgical ACL reconstruction, the BMD in the injured leg was significantly reduced relative to the control leg [S2: p=0.002, S3: p=0.002]. Post surgery, the proximal tibial BMD did not change in either leg [Control S2: p=0.102, S3: p=0.181; Injured S2: p=0.093, S3: p=0.439]. The post surgical images demonstrated patterns of increasing BMD surrounding the tunnel in the form of compact bone. A significant reduction in proximal tibial BMD was observed in the ACL injured legs relative to control legs. The pattern of pre-operative bone loss was generally observed to be global across the entire slice. No change in BMD was observed following ACL reconstruction, in either injured or control leg. These results indicate that proximal tibial BMD is reduced and does not change after ACL reconstruction.

AB - Following an anterior cruciate ligament (ACL) injury, the affected knee is known to experience bone loss and is at significant risk of becoming osteoporotic. Surgical reconstruction is performed to attempt to restore the function of the knee and theoretically restore this bone density loss. Cross-sectional analysis of the proximal tibia using peripheral quantitative computed tomography (pQCT) enables localised analysis of bone mineral density (BMD) changes. The aim of this study was to establish the pattern of bone density changes in the tibia pre- and post- ACL reconstruction using pQCT image analysis. Eight patients who underwent ACL reconstruction were included. A cross sectional analysis of the proximal tibia was performed using a pQCT scanner pre-operatively and one to two years post-operatively on both the injured and contralateral (control) knee. The proximal two and three percent slices [S2 and S3] along the tibia were acquired. These were exported to Matlab(tm) and automated segmentation was performed to remove the tibia from its surrounding structures. Cross correlation was applied to co-register pairs of images and patterns of change in BMD were mapped using a t-test (p<0.05). Connected components of pixels with significant change in BMD were created and used to assess the impact of ACL injury & reconstruction on the proximal tibial BMD. Prior to surgical ACL reconstruction, the BMD in the injured leg was significantly reduced relative to the control leg [S2: p=0.002, S3: p=0.002]. Post surgery, the proximal tibial BMD did not change in either leg [Control S2: p=0.102, S3: p=0.181; Injured S2: p=0.093, S3: p=0.439]. The post surgical images demonstrated patterns of increasing BMD surrounding the tunnel in the form of compact bone. A significant reduction in proximal tibial BMD was observed in the ACL injured legs relative to control legs. The pattern of pre-operative bone loss was generally observed to be global across the entire slice. No change in BMD was observed following ACL reconstruction, in either injured or control leg. These results indicate that proximal tibial BMD is reduced and does not change after ACL reconstruction.

KW - image analysis

KW - bone density

KW - anterior cruciate ligament injury

KW - bone loss

KW - osteoporotic

UR - http://www.bjjprocs.boneandjoint.org.uk/content/94-B/SUPP_XVIII/31.abstract

UR - http://www.thebioengsoc.org/meetings/bioengineering10

M3 - Conference Contribution

VL - 94-B

JO - Journal of Bone and Joint Surgery, British Volume

T2 - Journal of Bone and Joint Surgery, British Volume

JF - Journal of Bone and Joint Surgery, British Volume

SN - 0301-620X

IS - supp XVIII 31

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Findlay C, Jameson SS, Marshall S, Walker B, Walker C, Meek RMD et al. Image analysis of bone density following anterior cruciate ligament injury. Journal of Bone and Joint Surgery. 2010;94-B(supp XVIII 31).