Quantitative Assessment of Rotatory Instability after Anterior Cruciate Ligament Reconstruction

2009 ◽  
Vol 37 (5) ◽  
pp. 909-916 ◽  
Author(s):  
Yasutaka Tashiro ◽  
Ken Okazaki ◽  
Hiromasa Miura ◽  
Shuichi Matsuda ◽  
Takefumi Yasunaga ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Resonance Imaging ◽  
Rotatory Instability ◽  
Open Magnetic Resonance Imaging ◽  
Anterior Cruciate ◽  
Tibial Translation

Background Anterior cruciate ligament reconstruction successfully reduces anterior knee instability, but its effect on rotatory stability is not fully understood. In addition, a definitive method for the quantitative evaluation of rotatory instability remains to be established. Hypothesis Measurement of anterolateral tibial translation by open magnetic resonance imaging could positively correlate with the clinical grading of the pivot-shift test and would clarify residual rotatory abnormalities not shown by conventional methods for measurement of anterior stability. Study Design Controlled laboratory study. Methods An anterior cruciate ligament—reconstructed group (n = 21) and an anterior cruciate ligament—deficient group (n = 20) were examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Clinical knee stability was evaluated before the above measurement using the pivot-shift test, KT-2000 arthrometer, and stress radiography. A cutoff value for anterolateral tibial translation relating to pivot-shift was determined using a receiver operating characteristic curve. Results Side-to-side differences of anterolateral tibial translation correlated with clinical grade of the pivot-shift test and stress radiography but not with KT-2000 arthrometry in both groups. The cutoff value was established as 3.0 mm. Although the mean anterolateral translation showed no difference, 9 reconstructed knees revealed greater than 3 mm of anterolateral tibial translation, whereas only 3 uninjured knees did. Conclusion Measurement using an open magnetic resonance imaging successfully quantified the remaining rotatory instability in anterior cruciate ligament—reconstructed knees. Clinical Relevance This method is a useful means for quantifying anterior cruciate ligament function to stabilize tibial rotation.

Assessment of Anterolateral Rotatory Instability in the Anterior Cruciate Ligament—Deficient Knee Using an Open Magnetic Resonance Imaging System

2007 ◽  
Vol 35 (7) ◽  
pp. 1091-1097 ◽  
Author(s):  
Ken Okazaki ◽  
Hiromasa Miura ◽  
Shuich Matsuda ◽  
Takefumi Yasunaga ◽  
Hideaki Nakashima ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Resonance Imaging ◽  
Rotatory Instability ◽  
Anterolateral Rotatory Instability ◽  
Open Magnetic Resonance Imaging ◽  
Anterior Cruciate ◽  
Deficient Knee ◽  
Anterior Cruciate Ligament Deficient

Background In the clinical evaluation of the anterior cruciate ligament—deficient knee, anterolateral rotatory instability is assessed by manual tests such as the pivot-shift test, which is subjective and not quantitative. Hypothesis The anterolateral rotatory instability in an anterior cruciate ligament—deficient knee can be quantified by our newly developed method using open magnetic resonance imaging. Study Design Controlled laboratory study. Methods Eighteen subjects with anterior cruciate ligament—deficient knees and 18 with normal knees were recruited. We administered the Slocum anterolateral rotatory instability test in the open magnetic resonance imaging scanner and scanned the sagittal view of the knee. The anterior displacements of the tibia at the medial and lateral compartments were measured. Furthermore, we examined 14 anterior cruciate ligament—deficient knees twice to assess intraobserver and interobserver reproducibility and evaluated the difference and interclass correlation coefficient of 2 measures. Results In the anterior cruciate ligament—deficient knee, displacement was 14.4 ± 5.5 mm at the lateral compartment and 1.6 ± 2.3 mm at the medial compartment; in the normal knee, displacement was 0.7 ± 1.9 mm and —1.1 ± 1.2 mm, respectively. The difference and interclass correlation coefficient between 2 repeated measures at the lateral compartment were 1.0 ± 0.7 mm and .98 for intraobserver reproducibility and 1.1 ± 0.7 mm and .91 for interobserver reproducibility. Conclusion This method is useful to assess the anterolateral rotatory instability of the anterior cruciate ligament—deficient knee. Clinical Relevance This method can be used in the clinical assessment of anterior cruciate ligament stability, such as comparing studies of graft positions or 2-bundle anatomic reconstruction and the conventional 1-bundle technique.

Correlation between Knee Laxity and Graft Appearance on Magnetic Resonance Imaging after Double-Bundle Hamstring Graft Anterior Cruciate Ligament Reconstruction

2007 ◽  
Vol 35 (6) ◽  
pp. 936-942 ◽  
Author(s):  
Masaki Sonoda ◽  
Tsuguo Morikawa ◽  
Kan Tsuchiya ◽  
Hideshige Moriya
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Cruciate Ligament ◽  
Knee Laxity ◽  
Double Bundle ◽  
Pivot Shift Test ◽  
Resonance Imaging ◽  
Anterior Cruciate ◽  
High Intensity Signal

Background In recent years, double-bundle (anteromedial bundle [AMB], posterolateral bundle [PLB]) anterior cruciate ligament reconstruction has developed into an accepted practical surgical procedure; therefore, its efficacy needs to be established. Hypothesis Multiple-sliced 2-dimensional magnetic resonance imaging allows evaluation of each bundle separately. Both bundles are important for knee stability, and each bundle has a role in the prevention of knee instability. Knee laxity testing will correlate with the magnetic resonance imaging appearance of the individual graft bundles. Study Design Cohort study; Level of evidence, 2. Methods A total of 97 double-bundle anterior cruciate ligament reconstructions were evaluated 1 year after surgery, including side-to-side difference of KT-2000 arthrometer and pivot shift test. T2-weighted 2-dimensional magnetic resonance images were captured in the middle plane of each bundle to express magnetic resonance signals of each bundle. The magnetic resonance signals were divided into 3 grades: grade I, low-intensity signal; grade II, high-intensity signal within 50%; and grade III, high-intensity signal greater than 50%. Results Anterior laxity in AMB grade II (PLB I, 3.5 ± 1.7 mm; PLB II, 4.5 ± 1.9 mm) was significantly larger than in AMB grade I (PLB I, 1.9 ± 1.7 mm; PLB II, 2.1 ± 1.7 mm) with statistical difference (P = .025 in PLB I; P = .002 in PLB II). A positive rate in pivot shift test in PLB II (48%) was significantly larger than in PLB I (21%) with statistical difference (P = .031). Conclusions Varying magnetic resonance signals according to the bundle indicate role differences of each bundle in knee stability. These results imply that the AMB has a major role in preventing anterior translation of the tibia and the PLB has a major role in preventing anterolateral rotatory instability.

scholarly journals Passive Knee Stability After Anterior Cruciate Ligament Reconstruction Using the Endobutton or ToggleLoc With ZipLoop as a Femoral Fixation Device: A Comparison of 1654 Patients From the Danish Knee Ligament Reconstruction Registry

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877850 ◽  
Author(s):  
Christian Asmus Peter Asmussen ◽  
Mikkel Lindegaard Attrup ◽  
Kristian Thorborg ◽  
Per Hölmich
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Pivot Shift Test ◽  
Knee Stability ◽  
Knee Ligament ◽  
Knee Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Tibial Translation

Background: Biomechanical studies show varying results regarding the elongation of adjustable fixation devices. This has led to growing concern over the stability of the ToggleLoc with ZipLoop used in anterior cruciate ligament (ACL) reconstruction (ACLR) in vivo. Purpose/Hypothesis: The purpose of this study was to compare passive knee stability 1 year after ACLR in patients in whom the Endobutton or ToggleLoc with ZipLoop was used for femoral graft fixation. The hypothesis was that the ToggleLoc with ZipLoop would be inferior in knee stability to the Endobutton 1 year after primary ACLR. Study Design: Cohort study; Level of evidence, 2. Methods: Data from 3175 patients (Endobutton: n = 2807; ToggleLoc with ZipLoop: n = 368) were included from the Danish Knee Ligament Reconstruction Registry (DKRR) between June 2010 and September 2013. Data were retrieved from standardized ACL forms filled out by the operating surgeon preoperatively, during surgery, and at a clinical examination 1 year after surgery. Passive knee stability was evaluated using 1 of 2 arthrometers (Rolimeter or KT-1000 arthrometer) and the pivot-shift test. Using the same database, the number of reoperations performed up to 4 years after primary surgery was examined. Results: Full data were available for 1654 patients (Endobutton: n = 1538; ToggleLoc with ZipLoop: n = 116). ACLR with both devices resulted in increased passive knee stability ( P < .001). Patients who received the ToggleLoc with ZipLoop were found to have a better preoperative ( P = .005 ) and postoperative ( P < .001) pivot-shift test result. No statistically significant difference regarding the number of reoperations ( P = .086) or the time to reoperation ( P = .295) was found. Conclusion: Patients who underwent fixation with the ToggleLoc with ZipLoop had improved passive knee stability 1 year after surgery, measured by anterior tibial translation and pivot-shift test results, similar to patients who underwent fixation with the Endobutton. No difference was seen in knee stability or reoperation rates between the 2 devices.

The Role of Magnetic Resonance Imaging for Diagnosing Soft Tissue Lesions Associated with Anterior Cruciate Ligament Injuries

2018 ◽  
Vol 69 (9) ◽  
pp. 2498-2500
Author(s):  
Bogdan Sendrea ◽  
Antoine Edu ◽  
George Viscopoleanu
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Traumatic Event ◽  
Cruciate Ligament ◽  
Soft Tissue Injuries ◽  
Resonance Imaging ◽  
Soft Tissue Lesions ◽  
Anterior Cruciate

Magnetic resonance imaging has become the gold standard for soft tissue lesions evaluation especially after a traumatic event where there is need for diagnostic confirmation. The objective of the current paper was to evaluate the ability of magnetic resonance imaging in diagnosing soft tissue lesions in patients who underwent anterior cruciate ligament reconstruction compared with arthroscopic findings. Through the ability to diagnose soft tissue injuries, particularly meniscal lesions, magnetic resonance imaging should be considered as fundamental in guiding therapeutic management in patients with anterior cruciate ligament lesions.

Clinical Implications of Bone Bruise Patterns Accompanying Anterior Cruciate Ligament Tears

2021 ◽  
pp. 194173812110295
Author(s):  
Patrick Ward ◽  
Peter Chang ◽  
Logan Radtke ◽  
Robert H. Brophy
Keyword(s):  
Magnetic Resonance Imaging ◽  
Anterior Cruciate Ligament ◽  
Magnetic Resonance ◽  
Functional Outcomes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Bone Bruises ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are common injuries; they are often associated with concomitant injuries to other structures in the knee, including bone bruises. While there is limited evidence that bone bruises are associated with slightly worse clinical outcomes, the implications of bone bruises for the articular cartilage and the risk of developing osteoarthritis (OA) in the knee are less clear. Recent studies suggest that the bone bruise pattern may be helpful in predicting the presence of meniscal ramp lesions. Evidence Acquisition: A literature review was performed in EMBASE using the keyword search phrase (acl OR (anterior AND cruciate AND ligament)) AND ((bone AND bruise) OR (bone AND contusion) OR (bone AND marrow AND edema) OR (bone AND marrow AND lesion) OR (subchondral AND edema)). Study Design: Clinical review. Level of Evidence: Level 4. Results: The literature search returned 93 articles of which 25 were ultimately included in this review. Most studies identified a high prevalence of bone bruises in the setting of acute ACL injury. Individual studies have found relationships between bone bruise volume and functional outcomes; however, these results were not supported by systematic review. Similarly, the literature has contradictory findings on the relationship between bone bruises and the progression of OA after ACL reconstruction. Investigations into concomitant injury found anterolateral ligament and meniscal ramp lesions to be associated with bone bruise presence on magnetic resonance imaging. Conclusion: Despite the ample literature identifying the prevalence of bone bruises in association with ACL injury, there is little evidence to correlate bone bruises to functional outcomes or progression of OA. Bone bruises may best be used as a marker for concomitant injury such as medial meniscal ramp lesions that are not always well visualized on magnetic resonance imaging. Further research is required to establish the longitudinal effects of bone bruises on ACL tear recovery. Strength of Recommendation Taxonomy: 2.

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