Determination of the Transverse Centre of Rotation of the Knee Using CAT Scans

1986 ◽  
Vol 15 (3) ◽  
pp. 143-147 ◽  
Author(s):  
Michael E Brunet ◽  
Mark A Kester ◽  
Stephen D Cook ◽  
Ray J Haddad ◽  
Harry B Skinner
Keyword(s):  
Anterior Cruciate Ligament ◽  
Standard Deviation ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Computer Aided ◽  
Before And After ◽  
The Mean ◽  
Anterior Cruciate ◽  
Centre Of Rotation

Digitized serial CAT scans of four non-embalmed cadaver knees were used in the computer-aided determination of the longitudinal (internal-external) centres of rotation. The mean and standard deviation of the centre of rotation locations were calculated both before and after sectioning the anterior cruciate ligament. Regardless of anterior cruciate ligament status, the mean location of the centre of rotation was on the tibial spine, slightly anterior to the origin of the posterior cruciate ligament. However, upon sectioning of the anterior cruciate ligament, the standard deviation of the centre of rotation location increased markedly in the latero-medial direction in three of the four legs tested.

In Vitro Forces in the Normal and Cruciate-Deficient Knee During Simulated Squatting Motion

1999 ◽  
Vol 121 (2) ◽  
pp. 234-242 ◽  
Author(s):  
R. Singerman ◽  
J. Berilla ◽  
M. Archdeacon ◽  
A. Peyser
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Contact Force ◽  
Shear Force ◽  
Cruciate Ligament ◽  
Mean Value ◽  
Contact Forces ◽  
Flexion Angle ◽  
The Mean ◽  
Anterior Cruciate

Three orthogonal components of the tibiofemoral and patellofemoral forces were measured simultaneously for knees with intact cruciate ligaments (nine knees), following anterior cruciate ligament resection (six knees), and subsequent posterior cruciate ligament resection (six knees). The knees were loaded using an experimental protocol that modeled static double-leg squat. The mean compressive tibial force increased with flexion angle. The mean anteroposterior tibial shear force acted posteriorly on the tibia below 50 deg flexion and anteriorly above 55 deg. Mediolateral shear forces were low compared to the other force components and tended to be directed medially on both the patella and tibia. The mean value of the ratio of the resultant tibial force divided by the quadriceps force decreased with increasing flexion angle and was between 0.6 and 0.7 above 70 deg flexion. The mean value of the ratio of the resultant tibiofemoral contact force divided by the resultant patellofemoral contact force decreased with increasing flexion and was between 0.8 and 1.0 above 55 deg flexion. Cruciate ligament resection resulted in no significant changes in the patellar contact forces. Following resection of the anterior cruciate ligament, the tibial anteroposterior shear force was directed anteriorly over all flexion angles tested. Subsequent resection of the posterior cruciate ligament resulted in an approximately 10 percent increase in the quadriceps tendon and tibial compressive force.

scholarly journals MORPHOMETRIC ASSESSMENT OF FEMORAL CONDYLAR PARAMETERS IN GUJARAT REGION AND ITS CLINICAL RELEVANCE : AN OSTEOLOGICAL STUDY

2021 ◽  
Vol 9 (4) ◽  
pp. 645-648
Author(s):  
Abhinav Kumar Mishra ◽  
◽  
Achaleshwar Gandotra ◽  
Gyan Prakash Mishra ◽  
Navneet Kumar ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Lower Limb ◽  
Clinical Relevance ◽  
Cruciate Ligament ◽  
Anterior Side ◽  
The Mean ◽  
Anterior Cruciate ◽  
Morphometric Assessment ◽  
Femoral Groove

The Femur is the longest and strongest bone of the lower limb in which there is a groove present on anterior side and a notch present on posterior side. The anterior groove is called as patella-femoral groove and posterior notch is called Intercondylar (IC) Notch. There are two most important ligaments are connected with notch called Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL), associated by embryological and cognitive to the notch.The aim of this study is to find out the condylar parameters of femur. We obtained 50 completely ossified dry femur of both sides from Department of Anatomy, SBKSMIRC, Sumandeep Vidyapeeth. The Mean ± SDof femoral parameters were measured and correlation were also calculated between various parameters which is found to be positively correlated.It guides to the anatomists as well as Orthopaedicians and forensic practices also.

scholarly journals Novel quantification of the regional strain distribution in the anterior cruciate ligament in response to simulated loading using micro-CT imaging

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Alexandra M. Blokker ◽  
Ryan Wood ◽  
Jaques C. Milner ◽  
David W. Holdsworth ◽  
Timothy A. Burkhart ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Standard Deviation ◽  
Minimally Invasive ◽  
Cruciate Ligament ◽  
Ct Imaging ◽  
Micro Ct ◽  
Regional Strain ◽  
The Mean ◽  
Repeated Load ◽  
Anterior Cruciate

Abstract Purpose A large percentage of anterior cruciate ligament (ACL) surgical reconstructions experience sub-optimal outcomes within 2 years. A potential factor contributing to poor outcomes is an incomplete understanding of micro-level, regional ACL biomechanics. This research aimed to demonstrate a minimally invasive method that uses micro-CT imaging to quantify regional ACL strains under clinically relevant joint loading. Methods A pattern of 0.8 mm diameter zirconium dioxide beads were arthroscopically inserted into four regions of the ACL of four cadaveric knee specimens (mean [SD] age = 59 [9] years). A custom micro-CT compatible joint motion simulator then applied clinically relevant joint loading conditions, while an image was acquired at each condition. From the resulting images, strains within each region were calculated using the centroid coordinates of each tissue-embedded bead. Strain repeatability was assessed using the mean intra-specimen standard deviation across repeated load applications. A one-way repeated measures ANOVA (α = 0.05) was used to determine regional strain variations. Results The mean intra-specimen standard deviation across repeated load application was ±0.003 strain for all specimens. No statistically significant differences were found between tissue regions, although medium and large effect sizes (0.095–0.450) suggest that these differences may be clinically relevant. Conclusions The method presented here demonstrates a minimally invasive measurement of regional ACL strain under clinically relevant joint loads using micro-CT imaging. The strain measurements demonstrated excellent reliability across the five repeated load applications and suggest a non-homogenous distribution of strain through the ACL.

scholarly journals Autologous conditioned plasma in anterior cruciate ligament reconstruction with hamstrings – short term clinical results

2012 ◽  
Vol 18 (3) ◽  
pp. 111-115
Author(s):  
O.M. Russu ◽  
I. Gergely ◽  
Ancuța Zazgyva ◽  
I. Moldovan ◽  
T.S. Pop
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Interference Screw ◽  
Lysholm Score ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate

Abstract Evaluating the early clinical results of anterior cruciate ligament reconstruction using hamstrings autograft, with interference screw on the tibial side (biocomposite interference screw, ConMed-Linvatec) and continuous closed loop fixation on the femoral side (XO-Button, ConMed-Linvatec), with and without intra-articular injection of autologous conditioned plasma (ACP). Our study included 21 patients with chronic anterior cruciate ligament (ACL) ruptures for whom we performed ACL reconstruction with a hamstrings autograft. The mean age was 34 years (range, 25 to 42), 16 patients were men and 5 were women. In 10 cases we performed an intraarticular infiltration of ACP at the end of the surgical intervention. Final evaluation was performed at the end of the 6th postoperative month using the Lysholm scoring system, Tegner activity scale and objective assessment with the RolimeterTM 50A. The Lysholm score was excellent in all cases at 6 months postoperatively, with a mean Lysholm score of 90 for patients without ACP and 91.09 for patients that received ACP; the mean Tegner activity score was also similar pre- and postoperatively for the two groups (from 3.5 and 3.63 for the group without ACP and the group with ACP to 5.6 and 5.72 respectively). Joint laxity measurement was similar for both groups. We found no graft ruptures. We found similar results after ACL reconstruction with and without intra-articular injection of PRP, but further studies are necessary to determine the exact role of these substances in speeding up the recovery process in these cases.

Anterior Cruciate Ligament Mechanoreceptors and their Potential Importance in Remnant-Preserving Reconstruction: A Review of Basic Science and Clinical Findings

2017 ◽  
Vol 31 (08) ◽  
pp. 736-746 ◽  
Author(s):  
Jonathan Kosy ◽  
Vipul Mandalia
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Clinical Studies ◽  
Basic Science ◽  
Animal Studies ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Future Research ◽  
Remnant Preservation ◽  
Anterior Cruciate

AbstractMechanoreceptors, within the anterior cruciate ligament (ACL), are believed to have importance in proprioception, contributing to dynamic knee stability. The potential for reinnervation of the ACL graft is one of the proposed advantages of remnant-preserving reconstruction. The aim of this review is to summarize advances in the basic science underpinning this function, alongside recent clinical studies, to define the current role for remnant-preservation.A comprehensive systematic review was performed using PubMed and Medline searches. Studies were analyzed with particular focus placed on the methodology used to either identify mechanoreceptors or test proprioception.Contemporary work, using immunohistological staining, has shown mechanoreceptors primarily within proximity to the bony attachments of the ACL (peripherally in the subsynovial layer). The number of these receptors has been shown to decrease rapidly, following rupture, with adhesion to the posterior cruciate ligament slowing this decline. Recent studies have shown proprioceptive deficits, in both the injured and contralateral knees, with the clinical relevance of findings limited by testing methodology and the small differences found. The advantages of remnant-preservation, seen primarily in animal studies, have not been shown in systematic reviews or meta-analysis of clinical studies.The potential for reinnervation of the graft is likely time-dependent and reliant on continued loading of the remnant. Therefore, current clinical use and future research should focus on preserving remnants within 6 months of injury that remain loaded by adherence to the posterior cruciate ligament. Subsequent testing should account for central neurological changes and focus on clinically relevant outcomes.

The Shape and the Thickness of the Anterior Cruciate Ligament Along Its Length in Relation to the Posterior Cruciate Ligament: A Cadaveric Study

2013 ◽  
Vol 29 (12) ◽  
pp. 1963-1973 ◽  
Author(s):  
Eleni Triantafyllidi ◽  
Nikolaos K. Paschos ◽  
Anna Goussia ◽  
Nektaria-Marianthi Barkoula ◽  
Dimitrios A. Exarchos ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Cadaveric Study ◽  
Anterior Cruciate

Twenty-Year Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Prospectively Collected Data

2021 ◽  
pp. 036354652110273
Author(s):  
Joshua S. Everhart ◽  
Sercan Yalcin ◽  
Kurt P. Spindler
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Knee Function ◽  
Increased Risk ◽  
Patient Reported ◽  
The Mean ◽  
Anterior Cruciate

Background: Several long-term (≥20 years) follow-up studies after anterior cruciate ligament (ACL) reconstruction have been published in recent years, allowing for a systematic evaluation of outcomes. Purpose: To summarize outcomes at ≥20 years after ACL reconstruction and identify patient and surgical factors that affect these results. Study Design: Systematic review; Level of evidence, 4. Methods: Prospective studies of primary ACL reconstructions with hamstring or bone–patellar tendon—bone (BTB) autograft via an arthroscopic or a mini-open technique and with a mean follow-up of ≥20 years were identified. When possible, the mean scores for each outcome measure were calculated. Factors identified in individual studies as predictive of outcomes were described. Results: Five studies met the inclusion and exclusion criteria with a total of 2012 patients. The pooled mean follow-up for patient-reported outcome measures was 44.2% (range, 29.6%-92.7%) and in-person evaluation was 33.2% (range, 29.6%-48.9%). Four studies (n = 584) reported graft tears at a mean rate of 11.8% (range, 2%-18.5%) and 4 studies (n = 773) reported a contralateral ACL injury rate of 12.2% (range, 5.8%-30%). Repeat non-ACL arthroscopic surgery (4 studies; n = 177) to the ipsilateral knee occurred in 10.4% (range, 9.5%-18.3%) and knee arthroplasty (1 study; n = 217) in 5%. The pooled mean of the International Knee Documentation Committee subjective knee function (IKDC) score was 79.1 (SD, 21.8 [3 studies; n = 644]). In 2 studies (n?= 221), 57.5% of patients continued to participate in strenuous activities. The IKDC-objective score was normal or nearly normal in 82.3% (n = 496; 3 studies), with low rates of clinically significant residual laxity. Moderate-severe radiographic osteoarthritis (OA) (IKDC grade C or D) was present in 25.9% of patients (n = 605; 3 studies). Medial meniscectomy is associated with increased risk of radiographic OA. Radiographic OA severity is associated with worse patient-reported knee function, but the association with knee pain is unclear. Conclusion: Currently available prospective evidence for ACL reconstruction with hamstring or BTB autograft provides several insights into outcomes at 20 years. The rates of follow-up at 20 years range from 30% to 93%. IKDC-objective scores were normal or nearly normal in 82% and the mean IKDC-subjective score was 79 points.

The posterior cruciate ligament inclination angle is higher in anterior cruciate ligament insufficiency

2021 ◽  
Author(s):  
Julio Cesar Gali ◽  
Tyago Araujo Almeida ◽  
Daniela Cristina de Moraes Miguel ◽  
Samir Alexandre Nassar ◽  
Julio Cesar Gali Filho ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Posterior Cruciate Ligament ◽  
Inclination Angle ◽  
Cruciate Ligament ◽  
Anterior Cruciate

Injury to the Anterior Cruciate Ligament during Alpine Skiing

2002 ◽  
Vol 30 (4) ◽  
pp. 537-540 ◽  
Author(s):  
Sharon L. Hame ◽  
Daniel A. Oakes ◽  
Keith L. Markolf
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Alpine Skiing ◽  
Full Extension ◽  
Flexion Extension ◽  
Fresh Frozen ◽  
Full Flexion ◽  
The Mean ◽  
Anterior Cruciate ◽  
Knee Flexion Position

Background The anterior cruciate ligament has been shown to be particularly susceptible to injury during alpine skiing. Tibial torque is an important injury mechanism, especially when applied to a fully extended or fully flexed knee. Purpose We wanted to record the forces generated in the anterior cruciate ligament with application of tibial torque to cadaveric knees in different positions. Study Design Controlled laboratory study. Methods Thirty-seven fresh-frozen cadaveric knees were instrumented with a tibial load cell that measured resultant force in the anterior cruciate ligament while internal and external tibial torques were applied to the tibia at full extension, 90° of flexion, full flexion, and forced hyperflexion. Results At each knee flexion position, mean force generated by 10 N·m of internal tibial torque was significantly higher than the mean generated by 10 N·m of external tibial torque. Mean forces generated by tibial torque at 90° of flexion were relatively low. During flexion-extension without tibial torque applied mean forces were highest (193 N) when the knee was hyperflexed. Conclusions Application of internal tibial torque to a fully extended or fully flexed knee represents the most dangerous loading condition for injury from twisting falls during skiing. Clinical Relevance Understanding of the mechanisms of falls can be used to design better equipment and to better prevent or treat injury.

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