Femoral Trochlear Geometry in Patients with Trochlear Dysplasia Using MRI Oblique Trochlear View

2019 ◽  
Author(s):  
Luiz Felipe Ambra ◽  
Pedro Henrique Schmidt Alves Ferreira Galvão ◽  
Enzo Salviatto Mameri ◽  
Jack Farr ◽  
Andreas H. Gomoll
Keyword(s):  
Trochlear Dysplasia ◽  
Cruciate Ligament ◽  
Patellofemoral Instability ◽  
Trochlear Groove ◽  
Sulcus Angle ◽  
Sagittal Image ◽  
Level 3 ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate ◽  
Retrospective Comparative Study

AbstractThe objective of this study was to evaluate trochlear morphology in patients with trochlear dysplasia using a new oblique trochlear magnetic resonance imaging (MRI) view (OTV) in comparison with standard axial MRI sequences. MRI exam of 73 patients with patellofemoral instability (PFI) and the same number of controls were retrospectively reviewed. The oblique trochlear sequence was acquired by inclining the axial plane parallel to the intercondylar roof of the sagittal image, showing the anterior cruciate ligament (ACL) in its entire length. Trochlear morphology was assessed on axial and oblique trochlear sequences at three levels: level 1 at 25%, level 2 at 50%, and level 3 at 75% of the length of the trochlear groove. Trochlear sulcus angle and sulcus depth were measured at these three levels and compared between the new trochlear and standard axial sequences. Trochlear sulcus angle and sulcus depth were statistically different between axial and oblique trochlear views at all three levels (p < 0,05). Additionally, OTV displayed more uniform sulcus angle and depth along the trochlea. The oblique trochlear view on the MRI can more accurately evaluate trochlear morphology and also better characterize trochlear dysplasia in patients with PFI. This is Level III, retrospective comparative study.

How Do Axial Scan Orientation Deviations Affect the Measurements of Knee Anatomical Parameters Associated with Patellofemoral Instability? A Simulated Computed Tomography Study

2017 ◽  
Vol 31 (05) ◽  
pp. 425-432 ◽  
Author(s):  
Ran Xiong ◽  
Cheng Chen ◽  
Li Yin ◽  
Xiaoyuan Gong ◽  
Jiangming Luo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cruciate Ligament ◽  
Patellofemoral Instability ◽  
Ct Scanning ◽  
Tibial Tubercle ◽  
Trochlear Groove ◽  
Patellar Tilt ◽  
Sulcus Angle ◽  
Scan Data ◽  
Anatomical Parameters

AbstractThe purpose of this study was to detect the correlation between axial scan orientation discrepancy and the knee anatomical parameters associated with patellofemoral instability during computed tomography (CT) scanning. CT scan data of 16 knees from 16 healthy subjects were retrieved. The reslicing processes were performed to simulate different axial scan orientations generated due to leg adduction/abduction during CT scanning. Eight parameters (tibial tubercle to trochlear groove [TT-TG], tibial tubercle to posterior cruciate ligament [TT-PCL], patellar tilt, lateral trochlear inclination, sulcus angle, trochlear depth, trochlear facet asymmetry, and trochlear condyle asymmetry) of five angles (neutral zero, 4/8 degrees of adduction and 4/8 degrees abduction) were quantified. All eight parameters showed varying degrees of deviations to the different axial scan orientations. TT-TG, patellar tilt, lateral trochlear inclination, and trochlear condyle asymmetry were relatively sensitive to axial scan orientation changes, whereas TT-PCL, sulcus angle, trochlear depth, and trochlear facet asymmetry were relatively insensitive. Although the sensitivities are various, surgeons should be aware of this situation and make necessary corrections.

Value of Preoperative MRI and Examination under Anesthesia for Differentiating Complete from Partial Anterior Cruciate Ligament Tears

2018 ◽  
Vol 32 (07) ◽  
pp. 620-623 ◽  
Author(s):  
Leonardo Cavinatto ◽  
Sunny Gupta ◽  
Craig Morgan ◽  
Arthur R. Bartolozzi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Case Series ◽  
Single Bundle ◽  
Partial Tears ◽  
Prospective Case Series ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate ◽  
Patient Prognosis

AbstractPartial tears of the anterior cruciate ligament (ACL) recently regained attention due to a better understanding of the two distinct bundles of the ligament and the possibility of single-bundle reconstruction procedures. An accurate diagnosis is important as it influences treatment options and patient prognosis. The aim of this study was to evaluate the value of examination under anesthesia (EUA) and magnetic resonance imaging (MRI) for differentiating partial from complete ACL tears. For this purpose, this prospective case series included 95 consecutive patients undergoing primary ACL reconstruction surgeries. MRI, EUA, and MRI combined with EUA were performed preoperatively, and results were compared with arthroscopy. Our data showed that ACL lesions were diagnosed as partial tears in 42.1% (n = 40) of EUA, 23.2% (n = 22) of MRI, and 11.6% (n = 11) of arthroscopies. EUA and MRI demonstrated sensitivity of 100 and 90.1%, and specificity of 65.5 and 85.6%, respectively. Combined EUA and MRI demonstrated sensitivity of 100% and specificity of 83.1%. Our study revealed that preoperatively MRI and EUA may help surgeons early identify partial ACL tears and influence treatment decisions.

scholarly journals ACL partial tears: Is it possible to define which bundle is compromised using magnetic resonance?

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0020 ◽  
Author(s):  
Joaquín Stagnaro ◽  
Alejandro Rasumoff ◽  
Carlos H. Yacuzzi ◽  
Juan Pablo Zicaro ◽  
Matías Costa Paz
Keyword(s):  
Magnetic Resonance ◽  
Clinical Examination ◽  
Cruciate Ligament ◽  
Image Method ◽  
Diagnostic Image ◽  
Arthroscopic Findings ◽  
Partial Tears ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate ◽  
Pl Bundle

Objective: Anterior Cruciate Ligament (ACL) tears are diagnosed through a clinical examination and imaging confirmation. Magnetic Resonance Imaging (MRI) is the diagnostic image method of choice; however the sensitivity is variable for the different kind of partial injuries. The objective of this study is to evaluate the effectiveness of the MRI in the diagnosis of clinically unstable partial ACL tears that already underwent surgical treatment and define which bundle was compromised. Methods: A retrospective review of the preoperative MRI of 40 patients who were surgically operated because of ACL tears was executed. In all cases, arthroscopic findings defined one bundle was intact. All MRI were reviewed by a single osteo-articular specialist staff of the Image Department. All injuries were classified according to which bundle was involved (anteromedial (AM) or posterolateral (PL)). Results were compared with the surgical findings. Results: Concordance between MRI and arthroscopic findings was 42.5% (17/40 patients). If we analyze AM and PL tears separately we found that the concordance was 51.5% for AM bundle tears (17/33) and 0% for PL bundle tears (0/7). Conclusion: Definitive diagnosis and surgical indication for ACL tears requires both, clinical examination and image diagnosis. Over 65% of partial tears are misdiagnosed by MRI only.

scholarly journals Detection of early osteoarthritis in canine knee joints 3 weeks post ACL transection by microscopic MRI and biomechanical measurement

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877835 ◽  
Author(s):  
Daniel Mittelstaedt ◽  
David Kahn ◽  
Yang Xia
Keyword(s):  
Cruciate Ligament ◽  
Canine Model ◽  
Quantitative Mri ◽  
Early Developmental Stage ◽  
Early Osteoarthritis ◽  
Biomechanical Stress ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate ◽  
Transverse Resolution ◽  
Acl Transection

Purpose: To detect early osteoarthritis (OA) in a canine Pond–Nuki model 3 weeks after anterior cruciate ligament (ACL) transection surgery, both topographically over the medial tibial surface and depth-dependently over the cartilage thickness. Methods: Four topographical locations on each OA and contralateral medial tibia were imaged individually by magnetic resonance imaging (MRI) at 17.6 µm transverse resolution. The quantitative MRI T2 relaxation data were correlated with the biomechanical stress-relaxation measurements from adjacent locations. Results: OA cartilage was thinner than the contralateral tissue and had a lower modulus compared to the contralateral cartilage for the exterior, interior, and central medial tibia locations. Depth-dependent and topographical variations were detected in OA cartilage by a number of parameters (compressive modulus, glycosaminoglycan concentration, bulk and zonal thicknesses, T2 at 0° and 55° specimen orientations in the magnet). T2 demonstrated significant differences at varying depths between OA and contralateral cartilage. Conclusion: ACL transection caused a number of changes in the tibial cartilage at 3 weeks after the surgery. The characteristics of these changes, which are topographic and depth-dependent, likely reflect the complex degradation in this canine model of OA at the early developmental stage.

Isolated Medial Patellofemoral Ligament Reconstruction Can Be an Effective Procedure in Patellofemoral Instability with Risk Factors

2019 ◽  
Vol 33 (10) ◽  
pp. 992-997 ◽  
Author(s):  
Fabian Blanke ◽  
Kathrin Watermann ◽  
Maximilian Haenle ◽  
Andreas Feitenhansl ◽  
Carlo Camathias ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Medial Patellofemoral Ligament ◽  
Trochlear Dysplasia ◽  
Patellofemoral Instability ◽  
Effective Procedure ◽  
Mpfl Reconstruction ◽  
Trochlear Groove ◽  
Severe Problem ◽  
Outcome Scores

AbstractPatellofemoral instability is a severe problem in young and active patients. This pathology is influenced by ligamentous, bony, and neuromuscular parameters. The reconstruction of the medial patellofemoral ligament (MPFL) evolved to a primary procedure, but combined procedures were more frequently performed in the past years. However, additional operative procedures are associated with increased morbidity and no absolute indication can be identified in the literature. This study is intended to clarify whether addressing only ligamentous influence factors (MPFL) in chronic patellofemoral instability is sufficient to produce good clinical outcomes, or whether other risk factors influence the results negatively and should also be treated at some point. In 52 patients with chronic patellofemoral instability patellar height according to Caton-Deschamps, trochlear dysplasia according to Dejour, the leg axis, the femoral antetorsion, tibial tubercle (TT)–trochlear groove, and TT–posterior cruciate ligament distance were evaluated. All patients were treated with isolated MPFL reconstruction. After a minimum follow-up period of 24 months (24–36 months), the clinical outcome results were calculated using the scoring system according to Lysholm and Tegner. Correlation between clinical outcome scores and anatomic risk factors were calculated. The analysis was performed using a standard statistical software package (JMP version 12, SAS Institute, Cary, NC). The average postoperative Lysholm score increased significantly from 57.23 ± 19.9 to 85.9 ± 17.2 points (p < 0.0001) after isolated MPFL reconstruction. Moreover, the Tegner and Lysholm scores significantly improved both in patients without and with different risk factors postoperative. There were no significant differences in the outcome sores between the groups. Even the degree of trochlear dysplasia (types I–III) did not influence the results. Finally, there was no significant correlation found between all collected risk factors and the postoperative outcome scores. Isolated MPFL reconstruction can be an effective procedure in patients with patellofemoral instability and mild to moderate risk factors.

scholarly journals Morphometric parameters as risk factors for anterior cruciate ligament injuries: A MRI case-control study

2014 ◽  
Vol 71 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Lazar Stijak ◽  
Marko Bumbasirevic ◽  
Marko Kadija ◽  
Gordana Stankovic ◽  
Richard Herzog ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Control Group ◽  
Study Group ◽  
Matched Pairs ◽  
Intercondylar Notch ◽  
Anterior Cruciate Ligament Injuries ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate

Background/Aim. The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was to determine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. Methods. The study included 33 matched pairs of patients divided into two groups: the study group with the diagnosis of anterior cruciate ligament rupture, and the control group with the diagnosis of patellofemoral pain but no anterior cruciate ligament lesion. The patients were matched on the basis of 4 attributes: age, sex, type of lesion (whether it was profession- related), and whether the lesion was left- or right-sided. Measurements were carried out using magnetic resonance imaging (MRI). Results. The anterior and posterior edges of the anterior cruciate ligament in the control group were highly significantly smaller (p < 0.01; in both cases). The control group showed a statistically significantly larger width of the anterior cruciate ligament (p < 0.05). A significant correlation between the width of the anterior cruciate ligament and the width (p < 0.01) and height (p < 0.05) of the intercondylar notch was found to exist in the control group, but not in the study group (p > 0.05). The patients in the control group showed a shorter but wider anterior cruciate ligament in comparison to their matched pairs. The control group of patients was also characterized by the correlation between the width of the intercondylar notch and the width of the anterior cruciate ligament, which was not the case in the study group. Conclusions. According to the results of our study we can say that a narrow intercondylar notch contains a proportionally thin anterior cruciate ligament, but we cannot say that this factor necessarily leads to rupture of the anterior cruciate ligament.

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