The relationship of lower extremity alignments and anterior knee laxity to knee translations during a vertical drop landing

2011 ◽  
Vol 45 (4) ◽  
pp. 350-350
Author(s):  
C. A. Myers ◽  
J. E. Giphart ◽  
M. R. Torry ◽  
K. B. Shelburne ◽  
S. L. Y. Woo ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Knee Laxity ◽  
Anterior Knee Laxity ◽  
Drop Landing ◽  
Relationship Of ◽  
The Relationship ◽  
Anterior Knee

The Relationship between Grading and Instrumented Measurements of Anterior Knee Joint Laxity

2008 ◽  
Vol 17 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Wendy L. Hurley ◽  
Craig Denegar ◽  
William E. Buckley
Keyword(s):  
Athletic Trainers ◽  
Knee Laxity ◽  
Anterior Tibial Translation ◽  
Clinical Judgments ◽  
Certified Athletic Trainers ◽  
Anterior Knee Laxity ◽  
Anterior Tibial ◽  
Tibial Translation ◽  
The Relationship ◽  
Anterior Knee

Context:The relationship between clinical judgments of anterior knee laxity and instrumented measurement of anterior tibial translation is unclear.Objective:To examine the relationship between certified athletic trainers’ grading of anterior knee laxity and instrumented measurements of anterior tibial translation.Design:Randomized, blinded, clinical assessment.Setting:Laboratory.Participants:Model patients receiving evaluation of anterior knee laxity.Intervention:Twelve model patients were evaluated using a MEDmetric® KT1000™ knee ligament Arthrometer® to establish instrumented measurements of anterior translation values at the tibio-femoral joint. Twenty-two certified athletic trainers were provided with operational definitions of potential laxity grades and examined the model patients to make judgments of anterior knee laxity.Main Outcome Measures:Correlation between clinical judgments and instrumented measurements of anterior tibial translation.Results:Clinical judgments and instrumented measurements were mutually independent.Conclusions:Anterior tibial translation grading by certified athletic trainers should be interpreted with caution during clinical decision-making.

scholarly journals Relationship of anterior knee laxity to knee translations during drop landings: a bi-plane fluoroscopy study

2010 ◽  
Vol 19 (4) ◽  
pp. 653-662 ◽  
Author(s):  
Michael R. Torry ◽  
C. Myers ◽  
W. W. Pennington ◽  
K. B. Shelburne ◽  
J. P. Krong ◽  
...  
Keyword(s):  
Knee Laxity ◽  
Anterior Knee Laxity ◽  
Drop Landings ◽  
Relationship Of ◽  
Anterior Knee

Lower Extremity Posture is Related to Anterior Knee Laxity

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S93
Author(s):  
Sandra J. Shultz ◽  
Anh-Dung Nguyen ◽  
Beverly J. Levine ◽  
David H. Perrin
Keyword(s):  
Lower Extremity ◽  
Knee Laxity ◽  
Anterior Knee Laxity ◽  
Anterior Knee

scholarly journals The Relationship Between Lower Extremity Alignment Characteristics and Anterior Knee Joint Laxity

2009 ◽  
Vol 1 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Sandra J. Shultz ◽  
Anh-Dung Nguyen ◽  
Beverly J. Levine
Keyword(s):  
Lower Extremity ◽  
Pelvic Tilt ◽  
Knee Laxity ◽  
Tibiofemoral Angle ◽  
Navicular Drop ◽  
Lower Extremity Alignment ◽  
Anterior Knee Laxity ◽  
Genu Recurvatum ◽  
Anterior Pelvic Tilt ◽  
Anterior Knee

Background: Lower extremity alignment may influence the load distribution at the knee, potentially predisposing the anterior cruciate ligament to greater stress. We examined whether lower extremity alignment predicted the magnitude of anterior knee laxity in men and women. Hypothesis: Greater anterior pelvic angle, hip anteversion, tibiofemoral angle, genu recurvatum, and navicular drop will predict greater anterior knee laxity. Study Design: Descriptive laboratory study. Methods: Women (n = 122) and men (n = 97) were measured for anterior knee laxity and 7 lower extremity alignment variables on their dominant stance leg. Linear regression determined the extent to which the alignment variables predicted anterior knee laxity for each sex. Results: Lower anterior pelvic tilt and tibiofemoral angle, and greater genu recurvatum and navicular drop were related to greater anterior knee laxity in women, explaining 28.1% of the variance ( P < .001). Lower anterior pelvic tilt and greater hip anteversion, genu recurvatum and navicular drop were predictors of greater anterior knee laxity in men, explaining 26.5% of the variance ( P < .001). Conclusion: Lower anterior pelvic tilt, greater knee hyperextension, and foot pronation predicted greater anterior knee laxity in both men and women, with genu recurvatum and navicular drop having the greatest impact on anterior knee laxity. Greater hip anteversion was also a strong predictor in men, while a lower tibiofemoral angle was a significant predictor in women. Clinical Relevance: The associations between lower extremity alignment and anterior knee laxity suggest that alignment of the hip, knee, and ankle may be linked to or contribute to abnormal loading patterns at the knee, potentially stressing the capsuloligamentous structures and promoting greater joint laxity.

Effect of Tibial Tunnel Placement Using the Lateral Meniscus as a Landmark on Clinical Outcomes of Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652199967
Author(s):  
Kadir Büyükdoğan ◽  
Michael S. Laidlaw ◽  
Michael A. Fox ◽  
Michelle E. Kew ◽  
Mark D. Miller
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Lateral Meniscus ◽  
Knee Laxity ◽  
Pivot Shift Test ◽  
Anterior Knee Laxity ◽  
Posterior Group ◽  
Kt 1000 ◽  
Anterior Knee

Background: It remains unclear if use of the lateral meniscus anterior horn (LMAH) as a landmark will produce consistent tunnel positions in the anteroposterior (AP) distance across the tibial plateau. Purpose: To evaluate the AP location of anterior cruciate ligament (ACL) reconstruction tibial tunnels utilizing the LMAH as an intra-articular landmark and to examine how tunnel placement affects knee stability and clinical outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review was conducted of 98 patients who underwent primary ACL reconstruction with quadrupled hamstring tendon autografts between March 2013 and June 2017. Patients with unilateral ACL injuries and a minimum follow-up of 2 years were included in the study. All guide pins for the tibial tunnel were placed using the posterior border of the LMAH as an intra-articular landmark. Guide pins were evaluated with the Bernard-Hertel grid in the femur and the Stäubli-Rauschning method in the tibia. Patients were divided by the radiographic location of the articular entry point of the guide pin with relation to the anterior 40% of the tibial plateau. Outcomes were evaluated by the Marx Activity Scale and International Knee Documentation Committee (IKDC) form. Anterior knee laxity was evaluated using a KT-1000 arthrometer and graded with the objective portion of the IKDC form. Rotational stability was evaluated using the pivot-shift test. Results: A total of 60 patients were available for follow-up at a mean 28.6 months. The overall percentage of AP placement of the tibial tunnel was 39.3% ± 3.8% (mean ± SD; range, 31%-47%). Side-to-side difference of anterior knee laxity was significantly lower in the anterior group than the posterior group (1.2 ± 1.1 mm vs 2.5 ± 1.3 mm; P < .001; r = 0.51). The percentage of AP placement of the tibial tunnel demonstrated a positive medium correlation with side-to-side difference of anterior knee laxity as measured by a KT-1000 arthrometer ( r = 0.430; P < .001). The anterior group reported significantly better distribution of IKDC grading as compared with the posterior group (26 grade A and 6 grade B vs 15 grade A and 13 grade B; P = .043; V = 0.297). The pivot-shift test results and outcome scores showed no significant differences between the groups. Conclusion: Using the posterior border of the LMAH as an intraoperative landmark yields a wide range of tibial tunnel locations along the tibial plateau, with anterior placement of the tibial tunnel leading toward improved anterior knee stability.

Assessing Laxity Characteristics of Hyperextension Knee in Healthy Young Females Using a Knee Ligament Arthrometer

2007 ◽  
Author(s):  
Hsiu-Chen Lin ◽  
Weng-Hang Lai ◽  
Chia-Ming Chang ◽  
Horng-Chaung Hsu
Keyword(s):  
Female Athletes ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Acl Injury ◽  
Male Athletes ◽  
Knee Ligament ◽  
Young Females ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate ◽  
Anterior Knee

Female athletes are more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Previous study has showed that female individuals had larger anterior knee laxity than their male counterparts [1]. Researchers have also reported that knee laxity and hyperextension knee were a possible factor contributing to ACL injury [2]. Loudon showed that a person with hyperextension knee, either healthy or ACL-injured, had poorer proprioceptive control. Even more, ACL-injured subjects with hyperextension knee demonstrated a declined function of proprioception feedback loop and the ability to initiate protective reflexes [3].

scholarly journals Clinical Tests Can Be Used to Screen for Second Anterior Cruciate Ligament Injury in Younger Patients Who Return to Sport

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986300 ◽  
Author(s):  
Kate E. Webster ◽  
Julian A. Feller
Keyword(s):  
Anterior Cruciate Ligament ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Knee Laxity ◽  
Acl Injury ◽  
Anterior Knee Laxity ◽  
Anterior Cruciate ◽  
Clinical Measures ◽  
Anterior Knee

Background: Younger athletes have high rates of second anterior cruciate ligament (ACL) injury. Return-to-sport criteria have been proposed to enable athletes to make a safe return, but they frequently lack validation. It is unclear whether commonly recorded clinical measures can help to identify high-risk athletes. Purpose: To explore the association between commonly recorded clinical outcome measures and second ACL injury in a young, active patient group. Study Design: Cohort study; Level of evidence, 2. Methods: Included in this study were 329 athletes (200 males, 129 females) younger than 20 years at the time of first primary ACL reconstruction surgery who had subsequently returned to sport participation. Clinical examination included range of knee motion (passive flexion and extension deficits), instrumented anterior knee laxity, and single- and triple-crossover hop for distance. Patients also completed the subjective International Knee Documentation Committee form. All measures were collected prospectively at a 12-month postoperative clinical review. Patients were evaluated for a minimum 3 years to determine the incidence of subsequent ACL injury. Results: A total of 95 patients (29%) sustained a second ACL injury following clinical assessment and return to sport. There were 50 graft ruptures and 45 contralateral ACL injuries. Patients with a flexion deficit of 5° had over 2 times the odds of sustaining a graft rupture (odds ratio, 2.3; P < .05), and patients with a side-to-side difference in anterior knee laxity of 3 mm or greater had over 2 times the odds of sustaining a contralateral ACL injury (odds ratio, 2.4; P < .05). Overall, 29% (94 of 329) of patients met the threshold for satisfactory function on all 6 clinical measures; these patients had a 33% reduction in the risk of sustaining a second ACL injury ( P = .05) as compared with those who did not meet all clinical thresholds. Conclusion: Clinical measures of knee flexion and stability may have utility to screen for and identify patients who are at greater risk for a second ACL injury in an already high-risk group (ie, age and activity level).

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