{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T19:25:57Z","timestamp":1793820357480,"version":"4.6.1"},"reference-count":53,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003395","name":"shanghai municipal education commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003395","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"national natural science foundation of china","doi-asserted-by":"publisher","award":["No.12472327"],"award-info":[{"award-number":["No.12472327"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013068","name":"key technologies research and development program of guangzhou municipality","doi-asserted-by":"publisher","award":["No.2023B01J0022"],"award-info":[{"award-number":["No.2023B01J0022"]}],"id":[{"id":"10.13039\/501100013068","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anterior cruciate ligament reconstruction (ACLR) restores stability but is often followed by early cartilage degeneration. The contribution of altered dynamic contact pressure during gait to this degeneration remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To investigate the biomechanical mechanisms underlying early cartilage degeneration after ACLR, with a focus on dynamic contact pressure distribution during gait.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In a 3-year longitudinal magnetic resonance imaging (MRI) study of patients with ACLR (n = 30), cartilage thickness of the tibial plateau was quantitatively assessed using deep-learning-based 3-dimensional segmentation techniques. In parallel, cadaveric knees (n = 8) were tested under intact, ACL-deficient, and ACL-reconstructed conditions using a 6 degree-of-freedom robotic simulator replicating gait cycles. Tibiofemoral contact pressure and pressure center trajectories were recorded using pressure-sensitive film.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Quantitative MRI analyses revealed significant cartilage thinning in the posterior tibial subregion 3 years after ACLR. On the medial plateau, the central medial tibia, internal medial tibia, and posterior medial tibia subregions exhibited mean reductions of 10% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .027), 21% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .019), and 13% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .041), respectively. On the lateral plateau, significant decreases were observed in central lateral tibia (9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .031), posterior lateral tibia (14%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .029), and external lateral tibia (15%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .035). In robotic gait simulations, the reconstructed knees exhibited persistent posterior displacement of the whole-gait-cycle contact center of stress on both tibial plateaus (residual shifts: medial, 5.29 mm; lateral, 4.73 mm; both\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05). Additionally, the contact area was significantly enlarged in early stance (2%-12% gait cycle) and terminal swing (75%-100%), especially in the medial compartment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ACLR-induced pressure center displacement coincides with focal posterior cartilage degeneration, forming a spatiotemporal mechanical-pathological chain. This work highlights the potential of dynamic loading biomarkers for early osteoarthritis risk stratification and targeted mechanical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Persistent shifts in tibiofemoral pressure centers after ACLR coincide with focal cartilage thinning, suggesting a mechanical pathway to post-ACLR osteoarthritis. Identifying such dynamic loading biomarkers may guide early risk stratification and targeted interventions in sports medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465261456992","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T09:15:34Z","timestamp":1783674934000},"page":"2432-2445","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative Investigation of Tibiofemoral Cartilage Early Degeneration After ACL Reconstruction: An Integrated Biomechanical and Longitudinal MRI Analysis"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1150-0460","authenticated-orcid":false,"given":"Jinpeng","family":"Lin","sequence":"first","affiliation":[{"name":"School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, China"},{"name":"Department of Orthopaedics, Guangdong Provincial People's Hospital 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4658-3515","authenticated-orcid":false,"given":"Xiaolong","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China"},{"name":"Postdoctoral Workstation, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-4723","authenticated-orcid":false,"given":"Wenhan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Yuan","family":"Tsai","sequence":"additional","affiliation":[{"name":"School of Biomedical Engineering &amp; Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China"},{"name":"Engineering Research Center for Digital Medicine of the Ministry of Education, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlin","family":"Deng","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Medicine, Gannan Medical University, Ganzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaobai","family":"Wang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Rehabilitation 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