scholarly journals Morphometric parameters as risk factors for anterior cruciate ligament injuries: A MRI case-control study

2014 ◽  
Vol 71 (3) ◽  
pp. 271-276 ◽  
Author(s):  
Lazar Stijak ◽  
Marko Bumbasirevic ◽  
Marko Kadija ◽  
Gordana Stankovic ◽  
Richard Herzog ◽  
...  

Background/Aim. The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was to determine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. Methods. The study included 33 matched pairs of patients divided into two groups: the study group with the diagnosis of anterior cruciate ligament rupture, and the control group with the diagnosis of patellofemoral pain but no anterior cruciate ligament lesion. The patients were matched on the basis of 4 attributes: age, sex, type of lesion (whether it was profession- related), and whether the lesion was left- or right-sided. Measurements were carried out using magnetic resonance imaging (MRI). Results. The anterior and posterior edges of the anterior cruciate ligament in the control group were highly significantly smaller (p < 0.01; in both cases). The control group showed a statistically significantly larger width of the anterior cruciate ligament (p < 0.05). A significant correlation between the width of the anterior cruciate ligament and the width (p < 0.01) and height (p < 0.05) of the intercondylar notch was found to exist in the control group, but not in the study group (p > 0.05). The patients in the control group showed a shorter but wider anterior cruciate ligament in comparison to their matched pairs. The control group of patients was also characterized by the correlation between the width of the intercondylar notch and the width of the anterior cruciate ligament, which was not the case in the study group. Conclusions. According to the results of our study we can say that a narrow intercondylar notch contains a proportionally thin anterior cruciate ligament, but we cannot say that this factor necessarily leads to rupture of the anterior cruciate ligament.

2012 ◽  
Vol 69 (7) ◽  
pp. 576-580 ◽  
Author(s):  
Lazar Stijak ◽  
Milos Malis ◽  
Ruzica Maksimovic ◽  
Milan Aksic ◽  
Branislav Filipovic

Background/Aim. Morpohometric parameters of the intercondylar notch of femur present one of the substantial risk factors for rupture of the anterior cruciate ligament (ACL). In morphometric studies of the knee the most often referred indexes are notch width index and notch shape index. The aim of this study was to identificate the morphometric parameters of the intercondylar notch as risk factors for ACL rupture. Methods. This study included 99 patients divided into two groups: the study group (n = 57) composed of patients with chronic instability of the knee because of previos rupture of the ACL, and the control group (n = 42) composed of patients with lesion of the knee, but without rupture of the ACL. Measuring the width and height of intercondylar notch and epicondylar width was observed on a horizontal MR section. According to these values notch width and notch shape indexes were calculated. Results. The study group had statistically significantly higher (p < 0.05) intercondylar notch and lesser notch shape index than the control group (p < 0.05). The difference was highly statistically significant (p < 0.01) only in males, but not in females (p > 0.05). Absolute dimensions of the morphometric parameters of the distal part of the femur had highly statatistically significant larger values (p < 0.01) in males than females, exept in case of the intercondilar height in the control group (p > 0.05). Conclusion. Enhanced height of the intercondylar notch as well as lesser value of the notch shape index are associated with rupture of the ACL in males but not in females.


2010 ◽  
Vol 45 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Joseph M. Hart ◽  
Brian Pietrosimone ◽  
Jay Hertel ◽  
Christopher D. Ingersoll

Abstract Context: Arthrogenic muscle inhibition is an important underlying factor in persistent quadriceps muscle weakness after knee injury or surgery. Objective: To determine the magnitude and prevalence of volitional quadriceps activation deficits after knee injury. Data Sources: Web of Science database. Study Selection: Eligible studies involved human participants and measured quadriceps activation using either twitch interpolation or burst superimposition on patients with knee injuries or surgeries such as anterior cruciate ligament deficiency (ACLd), anterior cruciate ligament reconstruction (ACLr), and anterior knee pain (AKP). Data Extraction: Means, measures of variability, and prevalence of quadriceps activation (QA) failure (&lt;95%) were recorded for experiments involving ACLd (10), ACLr (5), and AKP (3). Data Synthesis: A total of 21 data sets from 18 studies were initially identified. Data from 3 studies (1 paper reporting data for both ACLd and ACLr, 1 on AKP, and the postarthroscopy paper) were excluded from the primary analyses because only graphical data were reported. Of the remaining 17 data sets (from 15 studies), weighted mean QA in 352 ACLd patients was 87.3% on the involved side, 89.1% on the uninvolved side, and 91% in control participants. The QA failure prevalence ranged from 0% to 100%. Weighted mean QA in 99 total ACLr patients was 89.2% on the involved side, 84% on the uninvolved side, and 98.5% for the control group, with prevalence ranging from 0% to 71%. Thirty-eight patients with AKP averaged 78.6% on the involved side and 77.7% on the contralateral side. Bilateral QA failure was commonly reported in patients. Conclusions: Quadriceps activation failure is common in patients with ACLd, ACLr, and AKP and is often observed bilaterally.


2020 ◽  
Vol 29 (6) ◽  
pp. 730-737 ◽  
Author(s):  
Hadi Akbari ◽  
Mansour Sahebozamani ◽  
Ablolhamid Daneshjoo ◽  
Mohammadtaghi Amiri-Khorasani ◽  
Yohei Shimokochi

Context: There is no evidence regarding the effect of the FIFA 11+ on landing kinematics in male soccer players, and few studies exist regarding the evaluating progress of interventions based on the initial biomechanical profile. Objective: To investigate the effect of the FIFA 11+ program on landing patterns in soccer players classified as at low or high risk for noncontact anterior cruciate ligament injuries. Design: Randomized controlled trial. Setting: Field-based functional movement screening performed at the soccer field. Participants: A total of 24 elite male youth soccer players participated in this study. Intervention: The intervention group performed the FIFA 11+ program 3 times per week for 8 weeks, whereas the control group performed their regular warm-up program. Main Outcome Measures: Before and after the intervention, all participants were assessed for landing mechanics using the Landing Error Scoring System. Pretraining Landing Error Scoring System scores were used to determine risk groups. Results: The FIFA 11+ group had greater improvement than the control group in terms of improving the landing pattern; there was a significant intergroup difference (F1,20 = 28.86, P < .001, ). Soccer players categorized as being at high risk displayed greater improvement from the FIFA 11+ program than those at low risk (P = .03). However, there was no significant difference in the proportion of risk category following the routine warm-up program (P = 1.000). Conclusions: The present study provides evidence of the usefulness of the FIFA 11+ program for reducing risk factors associated with noncontact anterior cruciate ligament injuries. The authors’ results also suggest that soccer players with the higher risk profile would benefit more than those with lower risk profiles and that targeting them may improve the efficacy of the FIFA 11+ program.


2011 ◽  
Vol 23 (03) ◽  
pp. 181-192
Author(s):  
Damoon Soudbakhsh ◽  
Elham Sahraei ◽  
Mehdi Bostan Shirin ◽  
Farzam Farahmand ◽  
Mohammad Naghi Tahmasebi ◽  
...  

Every year many people suffer from knee injuries. Previous studies on patients with knee injuries have shown that about 40% of knee injuries are Ligament injuries, and about 50% of the ligament injuries are the Anterior Cruciate Ligament (ACL) injuries. Along with other methods, knee arthrometers are widely used to diagnose ACL injuries. In the current research, a knee arthrometer was designed and developed to provide a reliable and repeatable measurement of knee laxity under anterior–posterior applied loads. Test–retest configurations to examine repeatability of the device resulted in less than 1.5-mm difference for more than 97% of tests under applied loads of up to 90 N. These tests included 166 tests on the left knees and 147 tests on the right knees of 37 healthy subjects. Also, this device was tested on 27 confirmed ACL ruptured patients, and the results were analyzed to find a better criterion than standard criteria to diagnose ACL rupture using knee arthrometers by finding specificity and sensitivity of the device using those criteria. Among the 20 criteria evaluated, a combination of side-to-side difference under 150 N of applied load, and CI@90-60 (compliance index calculated between 90 N, and 60 N) resulted in the best sensitivity (96.4%) and specificity (100%).


2022 ◽  
Vol 30 (1) ◽  
pp. 230949902110696
Author(s):  
Necip GÜVEN ◽  
Sezai ÖZKAN ◽  
Tulin TURKOZU ◽  
Adem YOKUS ◽  
Cihan ADANAS ◽  
...  

Purpose Many factors in the etiology of anterior cruciate ligament (ACL) tears, predisposing factors related to knee morphology have also been reported. This study aimed to determine whether the Insall–Salvati (IS) index, which measures patella height, is a predisposing risk factor for ACL tears. Methods The IS index, patellar length (PL), and patellar tendon length (PTL) values of patients (study group) that underwent arthroscopic reconstruction for ACL tears obtained by preoperative magnetic resonance imaging (MRI) were compared with the index values in the preoperative MRIs of patients that underwent knee arthroscopy for reasons besides ACL tears. In addition, the anterior tibial translation (ATT) of both groups was also measured and compared on MRI images. The MRI findings of the subjects included in both study groups were arthroscopically confirmed. Results The mean ages of the study group (n = 120) and control group (n = 90) were 29.1 ± 8.2 years and 31.8 ± 9.8 years, respectively. There was a statistically significant difference between the study and control groups in terms of the PL and PTL values ( p = 0.016 and p = 0.001, respectively). The IS index was statistically significantly higher in the study group with ACL tears ( p = 0.009). The ATT was 8.61 ± 4.68 mm in the study group and 3.80 ± 1.92 mm in the control group. The ATT results of both groups were evaluated, and it was found that the study group was significantly higher than the control group ( p = 0.001) Conclusions As a result of our current study, we observed higher IS index values in patients with ACL tears than in patients without ACL tears. It should be kept in mind that patella alta, which is associated with a high IS index as one of the factors of knee morphology associated with ACL tears, may play a role in the etiology of ACL tears.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Nazim Karahan ◽  
Ahmet Oztermeli ◽  
Serda Duman ◽  
Guzelali Ozdemir ◽  
Deniz Sonmez Cılız ◽  
...  

Background: Evaluating concomitant injury in patients with anterior cruciate ligament (ACL) rupture is important for predicting long-term results. Meniscofemoral ligament (MFL) rupture has been observed in patients with anterior cruciate ligament rupture in arthroscopic evaluation for ruptured ACL. Objectives: The objective of this study was to investigate the concomitant meniscofemoral ligaments injury in patients with anterior cruciate ligament ruptures via magnetic resonance imaging (MRI). Methods: A total of 200 patients (with ruptured ACL, n = 100; with intact ACL, n = 100) were retrospectively evaluated via MRI. In the group with ruptured ACL; the patients who were diagnosed as having noncontact ACL injuries and had undergone primary ACL reconstructions were included. The control group included 100 patients with suspected ACL rupture (from a similar injury mechanism) and whose MRI revealed an intact ACL. In the group with ruptured ACL, the time from injury to MRI was evaluated. A comparison of the presence of anterior MFL (aMFL) and posterior MFL (pMFL) between the two groups was evaluated. Results: In the ACL ruptured group, a significantly lower presence of aMFL or pMFL was observed compared to the control group (P = 0.001). The time from injury to MRI was significantly higher in the patients with absent MFL defined in MRI relative to the other groups (P = 0.001). Conclusions: We observed absence of MFLs (aMFL and pMFL) in a significant majority of patients with ruptured ACLs. Furthermore, we found a significant relationship between the time from injury to MRI and absence of MFL in the ruptured ACL group.


Author(s):  
Justina Marčiulionytė ◽  
Justinas Škikas ◽  
Saulė Sipavičienė

Background. Research aim was to analyze the quadriceps muscle strength recovery after anterior cruciate ligament reconstruction using electrical stimulation and physical therapy. Methods. There were two randomly selected groups, with eight people in each group. The selection criteria were that the subjects had to have anterior cruciate ligament operation six weeks prior and were very active physically. One group was for research (study group), the other one for reference (control group). The study group had electrical stimulation combined with physical therapy exercises two times a week, for 45 minutes. The control group had exercises to strengthen the quadriceps muscle also two times a week, for 45 minutes. Both groups were tested before and after the research. The things evaluated during the test were – visual pain scale (VAS) scores, quadriceps muscle strength during extension and flexion using (R. Lovett) scoring system and goniometry showing degrees of extension and flexion. Results. Comparing both study and control groups, there was statistically signifcant improvement (p < 0.05), however the study group recovered faster and had statistically greater benefts. Conclusions. After 6 weeks of physiotherapy, the range of motion, quadriceps muscle strength increased and pain decreased in the operated leg. 1. After 6 weeks of physiotherapy and electrical stimulation, the range of motion, quadriceps muscle strength increased and pain decreased in the operated leg. 2. After 6 weeks of physiotherapy and electrical stimulation, the range of motion, quadriceps muscle strength, pain in the operated leg changed more in the study group than in subjects who received only physical therapy.Keywords: anterior cruciate ligament, electrical stimulation, quadriceps muscle, ligament reconstruction, muscle strength.


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