An analysis of bone mineral density and bone metabolic markers for patients with anterior cruciate ligament reconstruction

CUI Cheng-wen; SHI Xiu-xiu; LI Xiao-ya; ZHOU Ying; SUN Hai-yan; LI Xiao

doi:10.3969/j.issn.2095-252X.2024.04.006

Abstract：Objective To analyze the characteristics of bone mineral density(BMD)and bone metabolism markers and their related factors in postoperative patients with anterior cruciate ligament(ACL)injury.Methods Postoperative patients with ACL injury who were hospitalized in our department and underwent rehabilitation treatment from July 2022 to July 2023 were selected as the observation group,and healthy persons who had medical checkups in the same period were selected as the control group.Clinical data including BMD,lumbar spine T-value,femoral neck T-value,bone metabolism markers,age,gender,body mass index(BMI),smoking and alcohol consumption were collected retrospectively to compare the differences between the two groups.The observation group was stratified according to the duration of injury for comparison of differences of clinical data.Meanwhile,correlation analysis was performed between BMD and clinical indicators to further explore the risk factors for BMD decline.Results The differences in BMD,lumbar spine T-value,and femoral neck T-value between the two groups were statistically significant(P<0.05).Differences in age,BMI,smoking,drinking,25-hydroxyvitamin D3,whole-segment parathyroid hormone,and procollagen type Ⅰ N-terminal propeptide(PINP)were not statistically significant(P>0.05).The patients in the observation group were divided into 4 groups(<3 months,3-6 months,6-12 months,and>12 months)according to the duration of injury,and the comparison between the two groups was statistically significant except for the difference in PINP(P<0.05).The differences of other clinical indicators were not statistically significant(P>0.05).The results of BMD examination(normal bone mass,low bone mass,osteoporosis)of the patients in the observation group were used as the dependent variable,and correlation analysis was conducted with other clinical indicators.The results showed that there was a significant positive correlation between decreased bone mineral density and age(r = 0.237,P<0.05),and a significant negative correlation with the values of osteocalcin and beta-isomerized type Ⅰ pro-crosslinked carboxy-terminal peptide(beta crosslaps,beta-CTX)(r =-0.376,P<0.01;r =-0.242,P<0.05).Conclusions There is a more generalized decrease in BMD in patients with ACL injury than in the normal population,and there is no significant difference in the results of BMD examination in patients of different injury duration subgroups.PINP,which reflects osteoclast activity,shows significant fluctuating changes with the increase of injury duration.Age,osteocalcin and β-CTX are significant risk factors for bone loss.