# Evaluating Over Constraint of the Patella following MPFL Reconstruction as a Contributing Factor to Progressive Cartilage Degradation

> **NIH NIH R01** · CLEVELAND CLINIC LERNER COM-CWRU · 2024 · $161,000

## Abstract

Project Summary/Abstract
Lateral patellar dislocation is a common traumatic injury for young, active subjects. Approximately 50% of
patients progress to symptomatic patellofemoral post-traumatic osteoarthritis (PTOA) by 25 years after
dislocation. Reconstruction of the medial patellofemoral ligament (MPFL) is currently the most popular approach
for surgical patellar stabilization. Stabilizing the patella to prevent additional dislocations is generally considered
preventative for progressive cartilage degradation that can initiate post-traumatic OA, but preliminary data
indicates ongoing patellofemoral cartilage degradation out to multiple years following MPFL reconstruction.
Preliminary data indicates over constraint of the patella following MPFL reconstruction adversely influences
cartilage. Aim 1 will characterize cartilage degradation for fifty patients following MPFL reconstruction for
comparison to twenty-five healthy controls. The MPFL reconstruction patients will be recruited at least five years
following surgery. All subjects will be evaluated at two time points, separated by two years. MRI-based T1ρ/T2
relaxation time mapping will quantify cartilage properties. Long T1ρ/T2 relaxation times indicate cartilage
degradation. The hypothesis for Aim 1 is that cartilage T1ρ/T2 relaxation times for the MPFL reconstruction group
will be longer than the control group and increase more dramatically over two years. Also, long T1ρ/T2 relaxation
times will be significantly correlated with morphological progression toward OA as well as pain and poor function
based on patient reported outcome measures (PROMs). Morphological grading will be based on comparisons
between post-operative MRI and previously acquired pre-operative MRI. PROMs will be quantified at each
evaluation and compared to an existing database of PROMs one year following MPFL reconstruction. Aim 2 will
correlate cartilage properties vs. patellofemoral constraint to determine if over constraint of the patella following
MPFL reconstruction contributes to progressive cartilage degradation. Measurements of knee alignment and
anatomy will characterize patellofemoral constraint. Changes in alignment from pre-operative to post-operative
MRI scans will be quantified. Weight-bearing cone beam CT will provide assessment of loaded alignment. The
hypothesis of Aim 2 is that measures indicating patellofemoral constraint will be significantly correlated with long
cartilage T1ρ/T2 relaxation times at least five years following MPFL reconstruction and progression of T1ρ/T2
relaxation times over the next two years. The data generated will immediately help guide patient selection and
surgical parameters for MPFL reconstruction to limit the risk of progressive cartilage degradation. The data will
also be used to design future clinical studies and trials focused on comparing MPFL reconstruction to other
treatment options and comparing between surgical parameters within MPFL reconstruction for patients at hig...

## Key facts

- **NIH application ID:** 10979973
- **Project number:** 1R01AR084758-01
- **Recipient organization:** CLEVELAND CLINIC LERNER COM-CWRU
- **Principal Investigator:** JOHN J ELIAS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $161,000
- **Award type:** 1
- **Project period:** 2024-08-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10979973

## Citation

> US National Institutes of Health, RePORTER application 10979973, Evaluating Over Constraint of the Patella following MPFL Reconstruction as a Contributing Factor to Progressive Cartilage Degradation (1R01AR084758-01). Retrieved via AI Analytics 2026-06-25 from https://api.ai-analytics.org/grant/nih/10979973. Licensed CC0.

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