scholarly journals Effects of Anterior Cruciate Ligament Deficiency on Tibiofemoral Cartilage Thickness and Strains in Response to Hopping

2018 ◽  
Vol 47 (1) ◽  
pp. 96-103 ◽  
Author(s):  
E. Grant Sutter ◽  
Betty Liu ◽  
Gangadhar M. Utturkar ◽  
Margaret R. Widmyer ◽  
Charles E. Spritzer ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Acl Injury ◽  
Cartilage Thickness ◽  
Intercondylar Notch ◽  
Dynamic Activity ◽  
Acl Deficiency ◽  
Anterior Cruciate ◽  
Acl Deficient ◽  
Deficient Knee

Background: Changes in knee kinematics after anterior cruciate ligament (ACL) injury may alter loading of the cartilage and thus affect its homeostasis, potentially leading to the development of posttraumatic osteoarthritis. However, there are limited in vivo data to characterize local changes in cartilage thickness and strain in response to dynamic activity among patients with ACL deficiency. Purpose/Hypothesis: The purpose was to compare in vivo tibiofemoral cartilage thickness and cartilage strain resulting from dynamic activity between ACL-deficient and intact contralateral knees. It was hypothesized that ACL-deficient knees would show localized reductions in cartilage thickness and elevated cartilage strains. Study Design: Controlled laboratory study. Methods: Magnetic resonance images were obtained before and after single-legged hopping on injured and uninjured knees among 8 patients with unilateral ACL rupture. Three-dimensional models of the bones and articular surfaces were created from the pre- and postactivity scans. The pre- and postactivity models were registered to each other, and cartilage strain (defined as the normalized difference in cartilage thickness pre- and postactivity) was calculated in regions across the tibial plateau, femoral condyles, and femoral cartilage adjacent to the medial intercondylar notch. These measurements were compared between ACL-deficient and intact knees. Differences in cartilage thickness and strain between knees were tested with multiple analysis of variance models with alpha set at P < .05. Results: Compressive strain in the intercondylar notch was elevated in the ACL-deficient knee relative to the uninjured knee. Furthermore, cartilage in the intercondylar notch and adjacent medial tibia was significantly thinner before activity in the ACL-deficient knee versus the intact knee. In these 2 regions, thinning was significantly influenced by time since injury, with patients with more chronic ACL deficiency (>1 year since injury) experiencing greater thinning. Conclusion: Among patients with ACL deficiency, the medial femoral condyle adjacent to the intercondylar notch in the ACL-deficient knee exhibited elevated cartilage strain and loss of cartilage thickness, particularly with longer time from injury. It is hypothesized that these changes may be related to posttraumatic osteoarthritis development. Clinical Relevance: This study suggests that altered mechanical loading is related to localized cartilage thinning after ACL injury.

Measuring Strain Distributions in the Anterior Cruciate Ligament Using Ultrasound

2010 ◽  
Author(s):  
Amy Cochran ◽  
Yingxin Gao ◽  
Ursula Krotscheck ◽  
Margret Thompson ◽  
James Stouffer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Treatment Strategies ◽  
Acl Injury ◽  
Physiological Factors ◽  
Detailed Understanding ◽  
Prevention And Treatment ◽  
Anterior Cruciate ◽  
Tissue Motion

Optimal prevention and treatment strategies of anterior cruciate ligament (ACL) injury can be realized with a detailed understanding of how physiological factors impact the ACL. A noninvasive, in vivo method that assesses the ACL’s mechanical integrity is needed to help clarify this multi-factorial pathophysiology. We investigated the use of the noninvasive, in vivo technique, ultrasound strain elastography (USE) (1), to distinguish between normal and injured ACLs. USE is used as a diagnostic tool in oncological (2), hepatic (3), and cardiovascular (4) applications. This technique uses ultrasonic RF data to track tissue motion in order to estimate strain within the tissue.

Lateral Extra-articular Tenodesis Contributes Little to Change In Vivo Kinematics After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

2021 ◽  
pp. 036354652110032
Author(s):  
Daisuke Chiba ◽  
Tom Gale ◽  
Kyohei Nishida ◽  
Felipe Suntaxi ◽  
Bryson P. Lesniak ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
P Value ◽  
In Vivo Kinematics ◽  
Acl Deficiency ◽  
Downhill Running ◽  
Value Range ◽  
Foot Strike ◽  
Anterior Cruciate

Background: Lateral extra-articular tenodesis (LET) in combination with anterior cruciate ligament (ACL) reconstruction (ACLR) has been proposed to improve residual rotatory knee instability in patients having ACL deficiency. Purpose/Hypothesis: The purpose was to compare the effects of isolated ACLR (iACLR) versus LET in combination with ACLR (ACLR+LET) on in vivo kinematics during downhill running. It was hypothesized that ACLR+LET would reduce the internal rotation of the reconstructed knee in comparison with iACLR. Study Design: Controlled laboratory study. Methods: A total of 18 patients with ACL deficiency were included. All participants were randomly assigned to receive ACLR+ LET or iACLR during surgery. Six months and 12 months after surgery, knee joint motion during downhill running was measured using dynamic biplane radiography and a validated registration process that matched patient-specific 3-dimensional bone models to synchronized biplane radiographs. Anterior tibial translation (ATT; positive value means “anterior translation”) and tibial rotation (TR) relative to the femur were calculated for both knees. The side-to-side differences (SSDs) in kinematics were also calculated (operated knee–contralateral healthy knee). The SSD value was compared between ACLR+LET and iACLR groups using a Mann-Whitney U test. Results: At 6 months after surgery, the SSD of ATT in patients who had undergone ACLR+LET (–1.9 ± 2.0 mm) was significantly greater than that in patients who had undergone iACLR (0.9 ± 2.3 mm) at 0% of the gait cycle (foot strike) ( P = .031). There was no difference in ATT 12 months after surgery. Regarding TR, there were no differences between ACLR+LET and iACLR at either 6 months ( P value range, .161-.605) or 12 months ( P value range, .083-.279) after surgery. Conclusion: LET in combination with ACLR significantly reduced ATT at the instant of foot strike during downhill running at 6 months after surgery. However, this effect was not significant at 12 months after surgery. The addition of LET to ACLR had no effect on TR at both 6 and 12 months after surgery. Clinical Relevance: LET in combination with ACLR may stabilize sagittal knee motion during downhill running in the early postoperation phase, but according to this study, it has no effect on 12-month in vivo kinematics. Registration: NCT02913404 ( ClinicalTrials.gov identifier)

Diagnostic of Injury Risk in the Anterior Cruciate Ligament Based On Shape Context Description of the Intercondylar Notch Curvature

2021 ◽  
Author(s):  
Joao Paulo Dias ◽  
Ariful Bhuiyan ◽  
Nabila Shamim
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
False Positives ◽  
Intercondylar Notch ◽  
Mr Images ◽  
Shape Context ◽  
Similarity Factor ◽  
Anterior Cruciate

Abstract An estimated number of 300,000 new anterior cruciate ligament (ACL) injuries occur each year in the United States. Although several magnetic resonance (MR) imaging-based ACL diagnostics methods have already been proposed in the literature, most of them are based on machine learning or deep learning strategies, which are computationally expensive. In this paper, we propose a diagnostics framework for the risk of injury in the anterior cruciate ligament (ACL) based on the application of the inner-distance shape context (IDSC) to describe the curvature of the intercondylar notch from MR images. First, the contours of the intercondylar notch curvature from 91 MR images of the distal end of the femur (70 healthy and 21 with confirmed ACL injury) were extracted manually using standard image processing tools. Next, the IDSC was applied to calculate the similarity factor between the extracted contours and reference standard curvatures. Finally, probability density functions of the similarity factor data were obtained through parametric statistical inference, and the accuracy of the ACL injury risk diagnostics framework was assessed using receiver operating characteristic analysis (ROC). The overall results for the area under the curve (AUC) showed that method reached a maximum accuracy of about 66%. Furthermore, the sensitivity and specificity results showed that an optimum discrimination threshold value for the similarity factor can be pursued that minimizes the incidence of false positives and false positives simultaneously.

scholarly journals Magnetic Tracking: A Novel Method of Assessing Anterior Cruciate Ligament Deficiency

2006 ◽  
Vol 88 (1) ◽  
pp. 16-17 ◽  
Author(s):  
RK Kundra ◽  
JD Moorehead ◽  
N Barton-Hanson ◽  
SC Montgomery
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tracking System ◽  
Cruciate Ligament ◽  
Magnetic Tracking ◽  
Lachman Test ◽  
Acl Deficiency ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tracking Device ◽  
Acl Deficient

INTRODUCTION The Lachman test is commonly performed as part of the routine assessment of patients with suspected anterior cruciate ligament (ACL) deficiency. A major drawback is its reliance on the clinician's subjective judgement of movement. The aim of this study was to quantify Lachman movement using a magnetic tracking device thereby providing a more accurate objective measure of movement. PATIENTS AND METHODS Ten patients aged 21–51 years were assessed as having unilateral ACL deficiency with conventional clinical tests. These patients were then re-assessed using a Polhemus Fastrak™ magnetic tracking device. RESULTS The mean anterior tibial displacement was 5.6 mm (SD = 2.5) for the normal knees and 10.2 mm (SD = 4.2) for the ACL-deficient knees. This gave an 82% increase in anterior tibial displacement for the ACL deficient knees. This was shown to be highly significant with P = 0.005. CONCLUSIONS The magnetic tracking system offers an objective quantification of displacements during the Lachman test. It is convenient, non-invasive and comfortable for the patient and is, therefore, ideally suited for use as an investigative tool.

Comparison of Gait Pattern in Athletes with ACL Deficiency and Healthy Individual using an Accelerometer

2020 ◽  
Vol 8 (1) ◽  
pp. 43 ◽  
Author(s):  
Heydar Sadeghi ◽  
Hesam Fazlali ◽  
Saba Sadeghi ◽  
Seyedmojtaba Seyedmojtaba Ojaghi
Keyword(s):  
Cruciate Ligament ◽  
Three Dimensional ◽  
Vertical Axis ◽  
Gait Pattern ◽  
Control Group ◽  
Acl Deficiency ◽  
Functional Capabilities ◽  
The Difference ◽  
Anterior Cruciate

Background: In athletes with anterior cruciate ligament (ACL) deficiencies could assess functional capabilities with different instruments such as use of a camera in vivo situation. However, these methods have suffered from a large number of limitations such as inability to be repeatable and complexity in technique. Objective: The main purpose of this study was to compare gait pattern of the athletes with ACL injury and able-bodied subjects using an accelerometer. Method: A three-dimensional accelerometer was placed over the tibia tuberosity of 20 healthy and 20 individuals with ACL-deficiencies (ACLD). After walking on the treadmill, the principal components of the acceleration data were calculated using MATLAB software. Results: In this study, Principle Component analysis was used for statistical analysis. The results indicated that subjects with ACL deficiency have different gait pattern compared to the control group. The major differences between stride trajectories of the two groups were at the end of mid-swing and the beginning of terminal swing phases in vertical axis. ACL deficient subjects exhibited different gait patterns during mid and terminal stance phases in anterior- posterior axis compared with normal controls. Conclusions: The difference in gait between subjects with ACL deficiency and healthy subjects are depends on variation in the amount of knee flexion and tibia rotation that could be altered to motor recruitment.

In-Vivo Force Estimation of the Anterior Cruciate Ligament

2009 ◽  
Author(s):  
Ali Hosseini ◽  
Thomas J. Gill ◽  
Guoan Li
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Force Estimation ◽  
Non Invasive ◽  
Injury Mechanisms ◽  
Invasive Method ◽  
Anterior Cruciate

The knowledge of in-vivo ACL forces is instrumental for understanding ACL injury mechanisms and for improving surgical ACL reconstruction techniques. Several in-vitro investigations have measured ACL forces in response to various loads applied to the knee. However, in-vivo ACL forces in response to controlled loading are still unknown. The objective of this study was to estimate the force of healthy ACL as well as the possible upper bound of ACL forces under an increasing axial tibial loading in living subjects using a non-invasive method.

Kinematic Analysis of Lateral Meniscal Oblique Radial Tears in the Anterior Cruciate Ligament–Deficient Knee

2021 ◽  
pp. 036354652110525
Author(s):  
Patrick A. Smith ◽  
Will A. Bezold ◽  
Cristi R. Cook ◽  
Aaron J. Krych ◽  
Michael J. Stuart ◽  
...  
Keyword(s):  
Pivot Shift ◽  
Cruciate Ligament ◽  
Joint Stability ◽  
Meniscal Extrusion ◽  
Anterior Drawer ◽  
Anterior Translation ◽  
Meniscus Root ◽  
Acl Deficiency ◽  
Anterior Cruciate ◽  
Acl Deficient

Background: Lateral meniscal oblique radial tears (LMORT) occur frequently in conjunction with anterior cruciate ligament (ACL) disruption and are anatomically distinct from meniscus root tears. Hypothesis/Purpose: The purpose of this study was to characterize the effects of LMORT types 3 (LMORT3) and 4 (LMORT4) lesions on joint stability and meniscal extrusion in ACL-deficient knees. Our hypothesis was that both lesions would promote significant increases in anterior translation and meniscal extrusion, with the LMORT4 lesion having a greater effect. Study Design: Controlled laboratory study. Methods: Two matched pairs of cadaveric knees (n = 4) were used to optimize the testing sequence. Additional cadaveric knees with LMORT3 (n = 8) and LMORT4 (n = 8) lesions created after ACL transection underwent robotic kinematic testing for anterior drawer and pivot-shift simulations with associated ultrasound-measured meniscal extrusion at clinically relevant knee flexion angles. Results: Optimization testing showed no differences on the effect of LMORT4 lesions for anterior translation and lateral meniscal extrusion with ACL-intact versus ACL-deficient knees. ACL deficiency and LMORT3 and LMORT4 lesions with ACL deficiency were associated with significantly greater anterior translation compared with ACL-intact state for both anterior drawer and pivot-shift testing at all flexion angles ( P < .001). ACL deficiency with either LMORT3 or LMORT4 lesion was associated with significantly greater anterior translation than was ACL deficiency only ( P < .005) for anterior drawer testing at 90° of flexion. Meniscal extrusion was greater with LMORT3 and LMORT4 lesions compared with ACL deficiency only ( P < .05) for anterior drawer at 60° of flexion and for pivot shift at 15° of flexion. The LMORT4 lesion demonstrated increased anterior translation for anterior drawer ( P = .003) at 60° of flexion (12%) as well as for pivot shift at 15° of flexion (7%) and 30° of flexion (13%) ( P < .005) compared with ACL deficiency only. Conclusion: In this cadaveric model, the addition of an LMORT3 or LMORT4 lesion increased anterior laxity for both the anterior drawer and the pivot shift when compared with an isolated ACL tear. Lateral meniscal extrusion was also exacerbated by these LMORT lesions. Clinical Relevance: LMORT lesions, distinct from meniscus root tears, occur frequently in conjunction with ACL tears. This study characterized the biomechanical consequences of LMORT3 and LMORT4 lesions on joint stability and meniscal function, highlighting the importance of diagnosing and treating LMORT lesions at the time of ACL reconstruction.

Time from Injury Is the Key Predictor of Meniscal Injury in ACL-Deficient Knees

2021 ◽  
Author(s):  
Seyed Mohammad Javad Mortazavi ◽  
Alireza Moharrami ◽  
S. S. Tamhri ◽  
Ali Okati ◽  
Ahmad Shamabadi
Keyword(s):  
Cruciate Ligament ◽  
Demographic Data ◽  
Meniscal Tear ◽  
Acl Injury ◽  
Meniscal Injury ◽  
Pain Visual Analog Scale ◽  
Initial Injury ◽  
Anterior Cruciate ◽  
And Gender ◽  
Acl Deficient

AbstractThe meniscus is one of the most important structures of the knee that needs to be saved if possible. Previous studies showed that increasing time from an anterior cruciate ligament (ACL) injury (TFI) could lead to a meniscal tear, especially medial meniscus (MM). We developed the present study to see if the TFI alone is a predictor of meniscal injury in ACL-deficient knees. We included 111 patients who had a reconstructed ACL injury at our institution from March 2015 to March 2016 in this retrospective cohort study. All demographic data, including age, gender, and body mass index (BMI), were collected. We also recorded the mechanism of injury and the TFI. We extracted the meniscal condition at the time of surgery from the surgical report. All patients were followed up for a mean of 23 months, and the Lysholm score and pain visual analog scale (VAS) score were obtained. The mean TFI of patients with MM tear was 17.4 ± 16.8 months, which was significant than the patients with lateral meniscal (LM) tear (9.3 ± 8.3 months) and intact meniscus (7.4 ± 8.1 months) (p = 0.001). Patients with TFI less than 6 months had a significantly lower rate of MM tear, and increasing TFI more than 6 months could increase the rate of MM tear (p = 0.001). We could not find any association between age, BMI, and gender and meniscal injury. At the latest follow-up, Lysholm and VAS scores in patients with and without meniscal tear were the same. Our study confirms that increasing time from the ACL injury would increase the risk of MM damage. The cutoff point for this risk factor is 6 months from initial injury; therefore, to save the meniscus, it might be better to perform ACL reconstruction within 6 months in ACL-deficient knees.

scholarly journals A Preliminary In Vivo Assessment of Anterior Cruciate Ligament–Deficient Knee Kinematics With the KneeM Device

2014 ◽  
Vol 2 (3) ◽  
pp. 232596711452558 ◽  
Author(s):  
Nicolas Tardy ◽  
Philippe Marchand ◽  
Pascal Kouyoumdjian ◽  
Dominique Blin ◽  
Christophe Demattei ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Anterior Cruciate ◽  
Deficient Knee ◽  
Anterior Cruciate Ligament Deficient ◽  
In Vivo Assessment

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.

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