In Vivo Joint Kinematics in Normal and Anterior Cruciate Ligament Injured Knees: Results of a Cine Phase Contrast Dynamic MRI Study

2003 ◽  
Author(s):  
Peter J. Barrance ◽  
Glenn N. Williams ◽  
Thomas S. Buchanan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Phase Contrast ◽  
Cruciate Ligament ◽  
Dynamic Mri ◽  
Anterior Tibial Translation ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Cine Phase Contrast ◽  
Acl Deficient

Cine phase contrast MRI, combined with a model-based rigid body tracking technique, was used to measure kinematics during a knee extension exercise in both knees of 16 anterior cruciate ligament (ACL) deficient surgical candidates and 16 uninjured subjects. A statistically significant increase in anterior tibial translation was observed in the ACL-deficient knees. Evidence of disruption to the screw-home mechanism was observed in the ACL-injured knees, although this was not a statistically significant result.

Mechanical Testing of a New Prosthetic Anterior Cruciate Ligament Using Biocompatible Fibrous Hydrogel Constructs

2011 ◽  
Author(s):  
Jason S. Bach ◽  
Fabrice Detrez ◽  
Frances R. Baxter ◽  
Sabine Cantournet ◽  
Mohammed Cherkaoui ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Donor Site ◽  
The United States ◽  
Long Term Results ◽  
Anterior Tibial Translation ◽  
Wide Range ◽  
Anterior Cruciate ◽  
Tibial Translation

The anterior cruciate ligament (ACL) is an important intra-articular structure in the knee joint that prevents excessive anterior tibial translation and resists internal rotational loads. Its rupture is one of the most common injuries of the knee and about 100,000 ACL reconstructions are performed each year in the United States. The current techniques for reconstruction involve replacing the ACL with autografts, most commonly from the hamstrings or patellar tendons, though use of these grafts is associated with various drawbacks, the most prominent of which is donor site morbidity. Over the past 30 years, numerous prosthetic devices for ACL replacement have been made with a wide range of materials. However none of them have demonstrated positive long term results in vivo, and no such devices are currently approved by the FDA for clinical use. Failures of previous devices mostly originate from a lack of biocompatibility due to immunogenic particulation or from mechanical failures causing prosthetic laxity and knee instability as the result of creep or rupture by wear and fatigue.

The Position of the Tibia during Graft Fixation Affects Knee Kinematics and Graft Forces for Anterior Cruciate Ligament Reconstruction

2001 ◽  
Vol 29 (6) ◽  
pp. 771-776 ◽  
Author(s):  
Jürgen Höher ◽  
Akihiro Kanamori ◽  
Jennifer Zeminski ◽  
Freddie H. Fu ◽  
Savio L-Y. Woo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Anterior Tibial Translation ◽  
Posterior Tibial ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Intact Knee

Ten cadaveric knees (donor ages, 36 to 66 years) were tested at full extension, 15°, 30°, and 90° of flexion under a 134-N anterior tibial load. In each knee, the kinematics as well as in situ force in the graft were compared when the graft was fixed with the tibia in four different positions: full knee extension while the surgeon applied a posterior tibial load (Position 1), 30° of flexion with the tibia at the neutral position of the intact knee (Position 2), 30° of flexion with a 67-N posterior tibial load (Position 3), and 30° of flexion with a 134-N posterior tibial load (Position 4). For Positions 1 and 2, the anterior tibial translation and the in situ forces were up to 60% greater and 36% smaller, respectively, than that of the intact knee. For Position 3, knee kinematics and in situ forces were closest to those observed in the intact knee. For Position 4, anterior tibial translation was significantly decreased by up to 2 mm and the in situ force increased up to 31 N. These results suggest that the position of the tibia during graft fixation is an important consideration for the biomechanical performance of an anterior cruciate ligament-reconstructed knee.

The Effectiveness of Reconstruction of the Anterior Cruciate Ligament Using the Novel Knot/Press-Fit Technique

2005 ◽  
Vol 33 (6) ◽  
pp. 856-863 ◽  
Author(s):  
Robert H.P. Kilger ◽  
Maribeth Thomas ◽  
Scott Hanford ◽  
Dimosthenis A. Alaseirlis ◽  
Hans H. Paessler ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Hamstring Tendon ◽  
Anterior Tibial Translation ◽  
Press Fit ◽  
Anterior Tibial ◽  
Tendon Grafts ◽  
Anterior Cruciate ◽  
Tibial Translation

Background A variety of fixation devices are used for anterior cruciate ligament reconstruction with hamstring tendon grafts. These devices increase costs and can present artifacts in magnetic resonance imaging as well as complications in revision surgery. Therefore, a novel knot/press-fit technique that requires no implantable devices has been introduced. Null Hypothesis The knot/press-fit technique restores knee kinematics as well as the more commonly used EndoButton CL fixation and has similar biomechanical properties as other devices published in the literature. Study Design Controlled laboratory study. Methods Eight fresh-frozen cadaveric knees (52 ± 7 years) were tested using a robotic/universal force-moment sensor testing system. The knee kinematics of the intact, anterior cruciate ligament-deficient, EndoButton-reconstructed, and knot/pressfit-reconstructed knee in response to both a 134-N anterior tibial load and a combined rotatory load at multiple knee flexion angles was determined. Differences between the 4 knee states were evaluated with a 2-factor repeated-measures analysis of variance (P <. 05). To determine the stiffness and strength of the knot/press-fit fixation, the femur-graft-tibia complex was tested in uniaxial tension. Results In response to an anterior tibial load, the anterior tibial translation for the knot/press-fit reconstruction was found to be not significantly different from that of the intact anterior cruciate ligament as well as that of the EndoButton reconstruction (P >. 05). In response to a combined rotatory load, neither reconstruction procedure could effectively reduce the coupled anterior tibial translation to that of the intact knee, and no significant difference between the 2 reconstructions could be detected (P >. 05). The stiffness of the knot/press-fit complex was found to be 37.8 ± 9.6 N/mm, and the load at failure was 540 ± 97.7 N, which is equal to other devices published in the literature. Clinical Relevance The experiment suggests that the knot/press-fit technique may be a reliable alternative for the femoral fixation of hamstring tendon grafts.

scholarly journals Insall–Salvati index is associated with anterior cruciate ligament tears in men: A Case-controlled study

2022 ◽  
Vol 30 (1) ◽  
pp. 230949902110696
Author(s):  
Necip GÜVEN ◽  
Sezai ÖZKAN ◽  
Tulin TURKOZU ◽  
Adem YOKUS ◽  
Cihan ADANAS ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Controlled Study ◽  
Control Group ◽  
Anterior Tibial Translation ◽  
Study Group ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
And Control ◽  
Tibial Translation

Purpose Many factors in the etiology of anterior cruciate ligament (ACL) tears, predisposing factors related to knee morphology have also been reported. This study aimed to determine whether the Insall–Salvati (IS) index, which measures patella height, is a predisposing risk factor for ACL tears. Methods The IS index, patellar length (PL), and patellar tendon length (PTL) values of patients (study group) that underwent arthroscopic reconstruction for ACL tears obtained by preoperative magnetic resonance imaging (MRI) were compared with the index values in the preoperative MRIs of patients that underwent knee arthroscopy for reasons besides ACL tears. In addition, the anterior tibial translation (ATT) of both groups was also measured and compared on MRI images. The MRI findings of the subjects included in both study groups were arthroscopically confirmed. Results The mean ages of the study group (n = 120) and control group (n = 90) were 29.1 ± 8.2 years and 31.8 ± 9.8 years, respectively. There was a statistically significant difference between the study and control groups in terms of the PL and PTL values ( p = 0.016 and p = 0.001, respectively). The IS index was statistically significantly higher in the study group with ACL tears ( p = 0.009). The ATT was 8.61 ± 4.68 mm in the study group and 3.80 ± 1.92 mm in the control group. The ATT results of both groups were evaluated, and it was found that the study group was significantly higher than the control group ( p = 0.001) Conclusions As a result of our current study, we observed higher IS index values in patients with ACL tears than in patients without ACL tears. It should be kept in mind that patella alta, which is associated with a high IS index as one of the factors of knee morphology associated with ACL tears, may play a role in the etiology of ACL tears.

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