scholarly journals Pathological changes of the anterior cruciate ligament autografts and some clinical-morphological correlations at the frontal-medial knee joint instability relapses

2013 ◽  
pp. 52-66
Author(s):  
V. V. Grigorovskiy ◽  
S. S. Strafun ◽  
S. V. Bogdan
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Joint Instability ◽  
Cruciate Ligament ◽  
Pathological Changes ◽  
Medial Knee ◽  
Anterior Cruciate

scholarly journals Comprehensive Assessment of Medial Knee Joint Instability by Valgus Stress MRI

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1433
Author(s):  
Malin Ciba ◽  
Eva-Maria Winkelmeyer ◽  
Justus Schock ◽  
Philipp Schad ◽  
Niklas Kotowski ◽  
...  
Keyword(s):  
Knee Joint ◽  
Joint Instability ◽  
Cruciate Ligament ◽  
Medial Compartment ◽  
Joint Models ◽  
Valgus Stress ◽  
Joint Injury ◽  
Medial Knee ◽  
Anterior Cruciate ◽  
Therapeutic Decision Making

Standard clinical MRI techniques provide morphologic insights into knee joint pathologies, yet do not allow evaluation of ligament functionality or joint instability. We aimed to study valgus stress MRI, combined with sophisticated image post-processing, in a graded model of medial knee joint injury. To this end, eleven human cadaveric knee joint specimens were subjected to sequential injuries to the superficial medial collateral ligament (sMCL) and the anterior cruciate ligament (ACL). Specimens were imaged in 30° of flexion in the unloaded and loaded configurations (15 kp) and in the intact, partially sMCL-deficient, completely sMCL-deficient, and sMCL- and ACL-deficient conditions using morphologic sequences and a dedicated pressure-controlled loading device. Based on manual segmentations, sophisticated 3D joint models were generated to compute subchondral cortical distances for each condition and configuration. Statistical analysis included appropriate parametric tests. The medial compartment opened gradually as a function of loading and injury, especially anteriorly. Corresponding manual reference measurements by two readers confirmed these findings. Once validated in clinical trials, valgus stress MRI may comprehensively quantify medial compartment opening as a functional imaging surrogate of medial knee joint instability and qualify as an adjunct diagnostic tool in the differential diagnosis, therapeutic decision-making, and monitoring of treatment outcomes.

scholarly journals Surgical Treatment of Combined Instability of the Knee Joint Caused by Damage to Three Stabilizing Ligaments (ACl, PCL, MCL). Clinical case

2021 ◽  
Vol 1 (56) ◽  
pp. 62-66
Author(s):  
Bagdat Balbosynov ◽  
◽  
Nurzhan Asanov ◽  
Marat Urazaev ◽  
Yerzhan Uteshev ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Joint Instability ◽  
Knee Injury ◽  
Clinical Case ◽  
Cruciate Ligament ◽  
Lateral Ligament ◽  
Lateral Ligaments ◽  
Anterior Cruciate ◽  
The Moment

This article presents a clinical case of combined injury of three ligaments (anterior and posterior cruciate and medial lateral ligaments) in a 46-year-old overweight woman (BMI = 38). The late diagnosed damage to the ligaments and the lack of conditions for their normal recovery led to combined instability of the knee joint and the appearance of indications for their reconstruction. At the moment, 6 weeks after the operation, the patient began to step independently on the operated limb, the range of permissible movements in the knee joint was flexion up to 90 degrees. The planned period of full recovery is 24 weeks. Key words: combined knee joint instability, posterior cruciate ligament, medial lateral ligament, anterior cruciate ligament, knee injury, clinical case.

The Analysis of Proprioception Alteration during First Five Months after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 1 (84) ◽  
Author(s):  
Vilma Jurevičienė ◽  
Albertas Skurvydas ◽  
Juozas Belickas ◽  
Giedra Bušmanienė ◽  
Dovilė Kielė ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Angular Velocity ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Starting Position ◽  
Angular Velocities ◽  
Anterior Cruciate

Research  background  and  hypothesis.  Proprioception  is  important  in  the  prevention  of  injuries  as  reduced proprioception  is  one  of  the  factors  contributing  to  injury  in  the  knee  joint,  particularly  the  ACL.  Therefore, proprioception appears not only important for the prevention of ACL injuries, but also for regaining full function after ACL reconstruction.Research aim. The aim of this study was to understand how proprioception is recovered four and five months after anterior cruciate ligament (ACL) reconstruction.Research methods. The study included 15 male subjects (age – 33.7 ± 2.49 years) who had undergone unilateral ACL reconstruction with a semitendinosus/gracilis (STG) graft in Kaunas Clinical Hospital. For proprioceptive assessment, joint position sense (JPS) was measured on both legs using an isokinetic dynamometer (Biodex), at knee flexion of 60° and 70°, and at different knee angular velocities of 2°/s and 10°/s. The patients were assessed preoperatively and after 4 and 5 months, postoperatively.Research results. Our study has shown that the JPS’s (joint position sense) error scores  to a controlled active movement is significantly higher in injured ACL-deficient knee than in the contralateral knee (normal knee) before surgery and after four and five months of rehabilitation.  After 4 and 5 months of rehabilitation we found significantly lower values in injured knees compared to the preoperative data. Our study has shown that in injured knee active angle reproduction errors after 4 and 5 months of rehabilitation were higher compared with the ones of the uninjured knee. Proprioceptive ability on the both legs was  independent of all differences angles for target and starting position for movement. The knee joint position sense on both legs depends upon the rate of two different angular velocities and the mean active angle reproduction errors at the test of angular velocity slow speed was the highest compared with the fast angular velocity. Discussion and conclusions. In conclusion, our study shows that there was improvement in mean JPS 4 and 5 months after ACL reconstruction, but it did not return to normal indices.Keywords: knee joint, joint position sense, angular velocity, starting position for movement.

Deconstructing the Anterior Cruciate Ligament: What We Know and Do Not Know About Function, Material Properties, and Injury Mechanics

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Mechanical Response ◽  
Cruciate Ligament ◽  
Complex Structure ◽  
Acute Injury ◽  
Research Attention ◽  
Increased Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.

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