Influence of Tibial Eminence Size on the ACL Injury

2011 ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Javad Hashemi ◽  
Ryan E. Breighner ◽  
James R. Slauterbeck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Ligament Injury ◽  
Tibial Eminence ◽  
Increased Risk ◽  
Anterior Cruciate

The geometry of the tibial plateau as well as the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of tibial eminence size as a potentially important characteristic of the tibial plateau in loading and or protecting the ACL from injury. The volume of Tibial eminence in 52 uninjured controls (32 women and 20 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and 3-d image reconstruction using commercial software Analyze 9.0. We hypothesized that the Individuals with a small tibial eminence are at increased risk of suffering an anterior cruciate ligament injury compared with those with larger tibial eminences. Based on t-tests, we established that the uninjured controls had larger tibial eminences (p<0.05) compared with the injured cases. Biomechanically speaking a larger tibial eminence could prevent excessive medio-lateral movement of femur with respect to the tibia. A larger eminence could also protect the knee from large magnitude rotational movements. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of the tibial eminence size in the risk of ACL injury.

Does the Curved Nature of the Tibia Influence the Non-Contact ACL Injury?

2012 ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Javad Hashemi ◽  
James R. Slauterbeck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Medial Compartment ◽  
Ligament Injury ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Matlab Programming

The geometry of the tibial plateau and the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of curved profile of the medial compartment of the tibia in a sagittal plane as a critical risk factor for the anterior cruciate ligament (ACL) injuries. The curvature of the mid-medial compartment of Tibia in 40 uninjured controls (21 women and 19 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and in-house matlab programming. We hypothesized that the Individuals with a less curved profile in the medial compartment of the tibia are at increased risk of suffering an anterior cruciate ligament injury compared to those with larger curved profiles. Based on t-tests, we established that the uninjured controls had larger curvature (p<0.05) compared to the injured cases. Biomechanically speaking a larger curvature of the tibia could prevent excessive sliding movement of femur with respect to the tibia, and thus could reduce the ACL strain. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of this curved profile of tibia in the risk of ACL injury.

scholarly journals A Comparison of Knee Abduction Angles Measured by a 3D Anatomic Coordinate System Versus Videographic Analysis: Implications for Anterior Cruciate Ligament Injury

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711881983 ◽  
Author(s):  
Zoë A. Englander ◽  
Hattie C. Cutcliffe ◽  
Gangadhar M. Utturkar ◽  
William E. Garrett ◽  
Charles E. Spritzer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Coordinate System ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Coronal Plane ◽  
Ligament Injury ◽  
Abduction Angle ◽  
Knee Abduction ◽  
Anterior Cruciate

Background: Knee positions involved in noncontact anterior cruciate ligament (ACL) injury have been studied via analysis of injury videos. Positions of high ACL strain have been identified in vivo. These methods have supported different hypotheses regarding the role of knee abduction in ACL injury. Purpose/Hypothesis: The purpose of this study was to compare knee abduction angles measured by 2 methods: using a 3-dimensional (3D) coordinate system based on anatomic features of the bones versus simulated 2-dimensional (2D) videographic analysis. We hypothesized that knee abduction angles measured in a 2D videographic analysis would differ from those measured from 3D bone anatomic features and that videographic knee abduction angles would depend on flexion angle and on the position of the camera relative to the patient. Study Design: Descriptive laboratory study. Methods: Models of the femur and tibia were created from magnetic resonance images of 8 healthy male participants. The models were positioned to match biplanar fluoroscopic images obtained as participants posed in lunges of varying flexion angles (FLAs). Knee abduction angle was calculated from the positioned models in 2 ways: (1) varus-valgus angle (VVA), defined as the angle between the long axis of the tibia and the femoral transepicondylar axis by use of a 3D anatomic coordinate system; and (2) coronal plane angle (CPA), defined as the angle between the long axis of the tibia and the long axis of the femur projected onto the tibial coronal plane to simulate a 2D videographic analysis. We then simulated how changing the position of the camera relative to the participant would affect knee abduction angles. Results: During flexion, when CPA was calculated from a purely anterior or posterior view of the joint—an ideal scenario for measuring knee abduction from 2D videographic analysis—CPA was significantly different from VVA ( P < .0001). CPA also varied substantially with the position of the camera relative to the participant. Conclusion: How closely CPA (derived from 2D videographic analysis) relates to VVA (derived from a 3D anatomic coordinate system) depends on FLA and camera orientation. Clinical Relevance: This study provides a novel comparison of knee abduction angles measured from 2D videographic analysis and those measured within a 3D anatomic coordinate system. Consideration of these findings is important when interpreting 2D videographic data regarding knee abduction angle in ACL injury.

scholarly journals Tibial Plateau Slopes in Indian Patients with or without Anterior Cruciate Ligament Injury: A Magnetic Resonance Imaging Study

2016 ◽  
Vol 24 (3) ◽  
pp. 289-293 ◽  
Author(s):  
Shyam Sundar ◽  
Sarthak Patnaik ◽  
Bobur Ubaydullaev ◽  
Vinodh Kolandavelu ◽  
David Rajan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Lateral Tibial Plateau ◽  
Indian Patients ◽  
Males And Females ◽  
Anterior Cruciate

Purpose To compare anterior cruciate ligament (ACL)–injured and ACL-intact patients as well as males and females in terms of tibial plateau slopes to determine their association with ACL injury. Methods Magnetic resonance images (MRI) of the knee of 310 male and 179 female skeletally mature Indian patients (mean age, 40 years) with (n=170+29) or without (n=140+150) ACL injury were reviewed. Their medial and lateral tibial plateau slopes (MTPS and LTPS), medial tibial plateau depth (MTPD), and lateral tibial plateau height (LTPH) were measured using MRI. Results The ACL-injured and ACL-intact groups were comparable in terms of MTPS (6.72° vs. 6.73°, p=0.07), LTPS (5.68° vs. 5.70°, p=0.09), MTD (1.74 vs. 1.73 mm, p=0.356), and LTH (2.21 vs. 2.22 mm, p=0.393). Males and females were also comparable in terms of MTPS and LTPS in both ACL-injured and ACL-intact groups. Conclusion ACL-injured and ACL-intact patients as well as males and females were comparable in terms of the tibial plateau slope parameters.

scholarly journals Is restricted hip movement a risk factor for anterior cruciate ligament injury?

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901879952
Author(s):  
Naoki Nakano ◽  
Jonathan Bartlett ◽  
Vikas Khanduja
Keyword(s):  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Clinical Studies ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Radiological Studies

Restricted hip movement along with femoroacetabular impingement (FAI) has been reported to be an important risk factor in anterior cruciate ligament (ACL) injury. We performed a literature review assessing the evidence that FAI, or restricted hip movement, contributes to the likelihood of sustaining an ACL injury to provide an evidence-based and comprehensive update on the relationship between these pathologies. Studies were divided into three categories: clinical studies, radiological studies and cadaveric studies. Clinical studies primarily assessed the limitations to hip movement in patients with ACL injury, and numerous studies of this kind have demonstrated a relationship between restricted movement and ACL injury. Radiological studies have been able to demonstrate a higher number of bony hip abnormalities in patients with ACL injury. However, due to variable results within these studies, it is unclear which kinds of bony abnormality are specifically associated with an increased risk of ACL injury. Cadaveric studies have demonstrated that peak ACL relative strain was inversely related to the range of internal rotation of the femur, thus providing a potential mechanism for this relationship. In conclusion, clinical and radiological studies have established a correlation between restricted hip and ACL injury, but have been unable to demonstrate an increased risk of future ACL injury in individuals with restricted hip movement. Future prospective cohort studies are necessary to confirm this. Additionally, these findings highlight the need for a thorough clinical assessment of the hip when assessing patients with an ACL injury.

scholarly journals Risk Factors for Anterior Cruciate Ligament Injury: literature Review: مخاطر الإصابة بالرباط الصليبي الأمامي: مراجعة أدبية

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Suleiman Ali Mansi
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Joint Stability ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Anterior Cruciate

  The Anterior cruciate ligament (ACL) plays an important role in maintaining knee-joint stability. Most ACL injures (approximately 65%) are due to a non-contact mechanism during physical activities, particularly in sports involving a landing from a jump, pivoting on the leg, rapid deceleration and cutting maneuvers. The average injury of ACL rates is still high for both professional and recreational athletes in particular between the group ages of 15 to 25 year old. The purpose of this article was to review and analysis the causes and potential risk factors for the ACL injury. Several anatomic and neuromuscular risk factors are associated with increased risk of suffering ACL injury, such as shoe-surface interaction, quadriceps angle, knee-joint laxity, genu varum of knee, and body composition. These risk factors most likely act in combination to influence the risk of ACL injury. Therefore, these factors should be considered when designing training programs, competitions, and implementing ACL injury prevention programs.

scholarly journals Relationship between intercondylar notch angle and anterior cruciate ligament injury: a magnetic resonance imaging analysis

2019 ◽  
Vol 47 (4) ◽  
pp. 1602-1609 ◽  
Author(s):  
Mengquan Huang ◽  
Yubiao Li ◽  
Naiming Guo ◽  
Chunlai Liao ◽  
Bin Yu
Keyword(s):  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Tibial Slope ◽  
Magnetic Resonance Images ◽  
Ligament Injury ◽  
Intercondylar Notch ◽  
Notch Angle ◽  
Anterior Cruciate

Objectives This study was performed to compare the intercondylar notch angle (INA) and tibial slope in patients with and without anterior cruciate ligament (ACL) injury and determine the risk factors and influence of these anatomic variations on ACL injury. Methods Participants with and without non-contact ACL injuries were included in the patient and control groups, respectively. The INA (formed by the femoral axis and Blumensaat line), lateral tibial slope (LTS), and medial tibial slope (MTS) were measured on magnetic resonance images. Comparisons were performed between the two groups. A binary logistic regression model was used to determine the influence of the variables on ACL injury. Results Fifty-two participants were included in each group. The INA was significantly smaller and the LTS was significantly greater in the patients than in the controls. No difference was found in the MTS between the two groups. The area under the receiver operating characteristic curve for the combination of the INA and LTS was 0.776 (95% confidence interval, 0.688–0.864). Conclusions The INA was smaller and the LTS was greater in patients with than without ACL tears. The INA in combination with the LTS could be used to predict ACL injury.

scholarly journals The Relationship between Anterior Cruciate Ligament Injury and Osteoarthritis of the Knee

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
David Simon ◽  
Randy Mascarenhas ◽  
Bryan M. Saltzman ◽  
Meaghan Rollins ◽  
Bernard R. Bach ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Surgical Reconstruction ◽  
Ligament Injury ◽  
Tibial Rotation ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
The Relationship

Anterior cruciate ligament (ACL) tears are a common injury, particularly in the athletic and youth populations. The known association between ACL injury and subsequent osteoarthritis (OA) of the knee merits a more in-depth understanding of the relationship between the ACL-injured knee and osteoarthritis. ACL injury, especially with concomitant meniscal or other ligamentous pathology, predisposes the knee to an increased risk of osteoarthritis. ACL insufficiency results in deterioration of the normal physiologic knee bending culminating in increased anterior tibial translation and increased internal tibial rotation. This leads to increased mean contact stresses in the posterior medial and lateral compartments under anterior and rotational loading. However, surgical reconstruction of the ACL has not been shown to reduce the risk of future OA development back to baseline and has variability based on operative factors of graft choice, timing of surgery, presence of meniscal and chondral abnormalities, and surgical technique. Known strategies to prevent OA development are applicable to patients with ACL deficiency or after ACL reconstruction and include weight management, avoidance of excessive musculoskeletal loading, and strength training. Reconstruction of the ACL does not necessarily prevent osteoarthritis in many of these patients and may depend on several external variables.

scholarly journals Lateral femoral notch sign and posterolateral tibial plateau fractures and their associated injuries in the setting of an anterior cruciate ligament rupture

2021 ◽  
Author(s):  
Alexander Korthaus ◽  
Malte Warncke ◽  
Geert Pagenstert ◽  
Matthias Krause ◽  
Karl-Heinz Frosch ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Ligament Injury ◽  
Ligament Rupture ◽  
Impression Fracture ◽  
Anterior Cruciate ◽  
Lateral Femoral Notch ◽  
Femoral Notch

Abstract Introduction ACL injury is one of the most common injuries of the knee joint in sports. As accompanying osseous injuries of the ACL rupture a femoral impression the so-called lateral femoral notch sign and a posterolateral fracture of the tibial plateau are described. However, frequency, concomitant ligament injuries and when and how to treat these combined injuries are not clear. There is still a lack of understanding with which ligamentous concomitant injuries besides the anterior cruciate ligament injury these bony injuries are associated. Materials and methods One hundred fifteen MRI scans with proven anterior cruciate ligament rupture performed at our center were retrospectively evaluated for the presence of a meniscus, collateral ligament injury, a femoral impression, or a posterolateral impression fracture. Femoral impressions were described according to their local appearance and posterolateral tibial plateau fractures were described using the classification of Menzdorf et al. Results In 29 cases a significant impression in the lateral femoral condyle was detected. There was a significantly increased number of lateral meniscal (41.4% vs. 18.6% p = 0.023) and medial ligament (41.4% vs. 22.1%; p = 0.040) injuries in the group with a lateral femoral notch sign. 104 patients showed a posterolateral bone bruise or fracture of the tibial plateau. Seven of these required an intervention according to Menzdorf et al. In the group of anterior cruciate ligament injuries with posterolateral tibial plateau fracture significantly more lateral meniscus injuries were seen (p = 0.039). Conclusion In the preoperative planning of ACL rupture accompanied with a positive femoral notch sign, attention should be paid to possible medial collateral ligament and lateral meniscus injuries. As these are more likely to occur together. A posterolateral impression fracture of the tibial plateau is associated with an increased likelihood of the presence of a lateral meniscal injury. This must be considered in surgical therapy and planning and may be the indication for necessary early surgical treatment.

scholarly journals DO TIBIAL EMINENCE FRACTURES AND ANTERIOR CRUCIATE LIGAMENT TEARS HAVE SIMILAR OUTCOMES?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0011
Author(s):  
Heath P. Melugin ◽  
Vishal S. Desai ◽  
Christopher Camp ◽  
Timothy E. Hewett ◽  
Todd A. Milbrandt ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Activity Levels ◽  
Injury Rates ◽  
Tibial Eminence ◽  
Anterior Laxity ◽  
Surgical Fixation ◽  
Anterior Cruciate

Background: Avulsion fractures involving the tibial eminence are considered equivalent in etiology to anterior cruciate ligament tears, however there is limited data comparing outcomes of adolescent patients undergoing surgical fixation of tibial eminence fractures to those undergoing anterior cruciate ligament (ACL) reconstruction. Purpose: The purpose of this study was to compare clinical outcomes, subsequent ACL injury rates, and activity levels between adolescent patients who underwent tibial eminence fracture fixation to patients with mid-substance ACL tears who required acute ligament reconstruction. Methods: This study included a group of patients with tibial eminence fractures treated with surgical fixation matched to a group of similar patients with ACL tears treated with reconstruction between the years of 2001 and 2015. Data regarding initial injury, surgical intervention, ACL/ACL graft injury rates, and physical examination findings were recorded. Clinical and functional outcomes were obtained using physical examination, IKDC subjective scores, Lysholm scores, and Tegner Activity levels. Results: Sixty patients with a mean follow-up of 57.7 (24-206) months were included. 20 patients (11 M:9 F) who underwent surgical fixation for tibial eminence fractures (TEF) with a mean age of 11.9 (7-15) years were matched to a group of 40 patients (23 M:17 F) who underwent ACL reconstruction for ACL tears with a mean age of 12.5 (8-15) years. The TEF group demonstrated significantly lower postoperative IKDC (TEF group: 94.0, ACL group: 97.2 (p=0.04)) and Lysholm scores (TEF group: 92.4, ACL group: 96.9 (p=0.02)). The TEF group returned to sport 121 days sooner (p<0.01), but there was no difference in postoperative Tegner scores (TEF group: 7.3, ACL group: 7.6 (p=0.16)). The TEF group demonstrated increased postoperative anterior laxity (p=0.02) and a higher rate of postoperative arthrofibrosis (p=0.04). There was no difference in subsequent ACL injury (p=0.41). Conclusion: Patients with tibial eminence fractures demonstrated lower mean clinical outcome scores compared to patients with ACL tears at minimum 2-year follow up. Additionally, they experienced more postoperative anterior laxity and had a higher rate of postoperative arthrofibrosis. There was no difference in subsequent ACL injury rate. The TEF group returned to sport sooner than the ACL group, but the postoperative activity level was similar.

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