scholarly journals The MRI posterior drawer test to assess posterior cruciate ligament functionality and knee joint laxity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lena Marie Wollschläger ◽  
Karl Ludger Radke ◽  
Justus Schock ◽  
Niklas Kotowski ◽  
David Latz ◽  
...  
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Joint Laxity ◽  
Knee Joints ◽  
Joint Models ◽  
Human Knee ◽  
Clinical Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Therapeutic Decision Making

AbstractClinical Magnetic Resonance Imaging (MRI) of joints is limited to mere morphologic evaluation and fails to directly visualize joint or ligament function. In this controlled laboratory study, we show that knee joint functionality may be quantified in situ and as a function of graded posterior cruciate ligament (PCL)-deficiency by combining MRI and standardized loading. 11 human knee joints underwent MRI under standardized posterior loading in the unloaded and loaded (147 N) configurations and in the intact, partially, and completely PCL-injured conditions. For each specimen, configuration, and condition, 3D joint models were implemented to analyse joint kinematics based on 3D Euclidean vectors and their projections on the Cartesian planes. Manual 2D measurements served as reference. With increasing PCL deficiency, vector projections increased significantly in the anteroposterior dimension under loading and manual measurements demonstrated similar patterns of change. Consequently, if combined with advanced image post-processing, stress MRI is a powerful diagnostic adjunct to evaluate ligament functionality and joint laxity in multiple dimensions and may have a role in differentiating PCL injury patterns, therapeutic decision-making, and treatment monitoring.

scholarly journals Evaluation of a posterior cruciate ligament deficient human knee joint finite element model

2014 ◽  
Vol 2014 (1) ◽  
pp. 21 ◽  
Author(s):  
Achilles Vairis ◽  
Markos Petousis ◽  
Nectarios Vidakis ◽  
Betina Kandyla ◽  
Andreas-Marios Tsainis
Keyword(s):  
Finite Element ◽  
Knee Joint ◽  
Finite Element Model ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Element Model ◽  
Human Knee ◽  
Human Knee Joint

scholarly journals Comprehensive Assessment of Medial Knee Joint Instability by Valgus Stress MRI

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1433
Author(s):  
Malin Ciba ◽  
Eva-Maria Winkelmeyer ◽  
Justus Schock ◽  
Philipp Schad ◽  
Niklas Kotowski ◽  
...  
Keyword(s):  
Knee Joint ◽  
Joint Instability ◽  
Cruciate Ligament ◽  
Medial Compartment ◽  
Joint Models ◽  
Valgus Stress ◽  
Joint Injury ◽  
Medial Knee ◽  
Anterior Cruciate ◽  
Therapeutic Decision Making

Standard clinical MRI techniques provide morphologic insights into knee joint pathologies, yet do not allow evaluation of ligament functionality or joint instability. We aimed to study valgus stress MRI, combined with sophisticated image post-processing, in a graded model of medial knee joint injury. To this end, eleven human cadaveric knee joint specimens were subjected to sequential injuries to the superficial medial collateral ligament (sMCL) and the anterior cruciate ligament (ACL). Specimens were imaged in 30° of flexion in the unloaded and loaded configurations (15 kp) and in the intact, partially sMCL-deficient, completely sMCL-deficient, and sMCL- and ACL-deficient conditions using morphologic sequences and a dedicated pressure-controlled loading device. Based on manual segmentations, sophisticated 3D joint models were generated to compute subchondral cortical distances for each condition and configuration. Statistical analysis included appropriate parametric tests. The medial compartment opened gradually as a function of loading and injury, especially anteriorly. Corresponding manual reference measurements by two readers confirmed these findings. Once validated in clinical trials, valgus stress MRI may comprehensively quantify medial compartment opening as a functional imaging surrogate of medial knee joint instability and qualify as an adjunct diagnostic tool in the differential diagnosis, therapeutic decision-making, and monitoring of treatment outcomes.

scholarly journals Evaluation of Knee Joint after Open Reduction and Internal Fixation Surgery of Posterior Cruciate Ligament in Patients with Avulsion Fracture

2019 ◽  
Vol 7 (6) ◽  
pp. 982-986
Author(s):  
Navid Salehi ◽  
Faeze Azarifar ◽  
Arman Jahanshahi ◽  
Hamidreza Mohammadi
Keyword(s):  
Knee Joint ◽  
Internal Fixation ◽  
Posterior Cruciate Ligament ◽  
Open Reduction ◽  
Avulsion Fracture ◽  
Cruciate Ligament ◽  
Common Mechanism ◽  
Knee Score ◽  
Normal Knee ◽  
Lysholm Knee Score

BACKGROUND: The posterior cruciate ligament is one of the important tissues and structures sustaining the knee joint, and its rupture or detachment may lead to joint instability or destruction. AIM: The present study aimed at investigating the Open Reduction and Internal Fixation surgery of posterior cruciate ligament and comparing it to the normal knee of the same side. METHODS: In this study, 25 patients with avulsion fracture at the PCL joint were treated with open surgery and screw fixation. The patients were followed up by Lysholm knee score for at least 12 months after surgery. RESULTS: All patients were male with an average age of 25 years over the years 2010-2018. The common mechanism of injury in these patients was motorcycle-car accident. In the study with Lysholm knee score, 21 patients (80%) obtained the good score of 60-90 while 20% of patients were placed in the fair group (30-59). The average score was 86. CONCLUSION: The obtained score of knee function questionnaire in this study had no significant difference from other similar studies, and most patients achieved a good and acceptable score after the surgery. There was no knee instability and functional impairment in the patients compared to the normal knee. Considering the clinical results after the fixation of the PCL avulsion fracture causing a significant improvement in patients, the surgery could be considered as an acceptable and effective method for treating such impairment and fracture.

scholarly journals The Assessment of the Condition of Knee Joint Surfaces with Acoustic Emission Analysis

Sensors ◽  
2021 ◽  
Vol 21 (19) ◽  
pp. 6495
Author(s):  
Bartłomiej Sawaryn ◽  
Natalia Piaseczna ◽  
Szymon Sieciński ◽  
Rafał Doniec ◽  
Konrad Duraj ◽  
...  
Keyword(s):  
Knee Joint ◽  
Knee Injury ◽  
Knee Joints ◽  
Resonance Imaging ◽  
Emission Analysis ◽  
X Ray ◽  
Joint Surfaces ◽  
Magnetic Resonance Imaging Mri ◽  
Leg Movements ◽  
Acoustic Emission Analysis

The knee joint, being the largest joint in the human body, is responsible for a great percentage of leg movements. The diagnosis of the state of knee joints is usually based on X-ray scan, ultrasound imaging, computerized tomography (CT), magnetic resonance imaging (MRI), or arthroscopy. In this study, we aimed to create an inexpensive, portable device for recording the sound produced by the knee joint, and a dedicated application for its analysis. During the study, we examined fourteen volunteers of different ages, including those who had a knee injury. The device effectively enables the recording of the sounds produced by the knee joint, and the spectral analysis used in the application proved its reliability in evaluating the knee joint condition.

Studying the Intact, ACL-Deficient and Reconstructed Human Knee Joint Using a Finite Element Model

2013 ◽  
Author(s):  
Achilles Vairis ◽  
Markos Petousis ◽  
George Stefanoudakis ◽  
Nectarios Vidakis ◽  
Betina Kandyla ◽  
...  
Keyword(s):  
Finite Element ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Element Model ◽  
Human Knee ◽  
Mechanical Responses ◽  
Human Knee Joint ◽  
Calculated Load ◽  
Anterior Cruciate

The human knee joint has a three dimensional geometry with multiple body articulations that produce complex mechanical responses under loads that occur in everyday life and sports activities. Knowledge of the complex mechanical interactions of these load bearing structures is of help when the treatment of relevant diseases is evaluated and assisting devices are designed. The anterior cruciate ligament in the knee connects the femur to the tibia and is often torn during a sudden twisting motion, resulting in knee instability. The objective of this work is to study the mechanical behavior of the human knee joint in typical everyday activities and evaluate the differences in its response for three different states, intact, injured and reconstructed knee. Three equivalent finite element models were developed. For the reconstructed model a novel repair device developed and patented by the authors was employed. For the verification of the developed models, static load cases presented in a previous modeling work were used. Mechanical stresses calculated for the load cases studied, were very close to results presented in previous experimentally verified work, in both load distribution and maximum calculated load values.

scholarly journals Simulation Analysis of Knee Ligaments in the Landing Phase of Freestyle Skiing Aerial

2019 ◽  
Vol 9 (18) ◽  
pp. 3713 ◽  
Author(s):  
Yanming Fu ◽  
Xin Wang ◽  
Tianbiao Yu
Keyword(s):  
Knee Joint ◽  
Mechanical Response ◽  
Simulation Analysis ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Element Model ◽  
Knee Joints ◽  
Internal Stresses ◽  
Risk Of Injury ◽  
Medium Risk

The risk of knee injuries in freestyle skiing athletes that perform aerials is high. The internal stresses in the knee joints of these athletes cannot easily be directly measured. In order to ascertain the mechanical response of knee joints during the landing phase, and to explore the mechanism of damage to the cartilage and ligaments, a finite element model of the knee joint was established. Three successful landing conditions (neutral, backward, or forward landing) from a triple kicker were analyzed. The results demonstrate that the risk of cruciate ligament damage during a neutral landing was lowest. A forward landing carried medium risk, while backward landing was of highest risk. Backward and forward landing carried risk of injury to the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), respectively. The magnitude of stress on the meniscus and cartilage varied for all three landing scenarios. Stress was largest during neutral landing and least in backward landing, while forward landing resulted in a medium level of stress. The results also provide the basis for training that is scientifically robust so as to reduce the risk of injury and assist in the development of a professional knee joint protector.

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