scholarly journals Micro- and Macroscale Assessment of Posterior Cruciate Ligament Functionality Based on Advanced MRI Techniques

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1790
Author(s):  
Lena Marie Wilms ◽  
Karl Ludger Radke ◽  
Daniel Benjamin Abrar ◽  
David Latz ◽  
Justus Schock ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Structural Integrity ◽  
T2 Mapping ◽  
Cruciate Ligament ◽  
Texture Features ◽  
Knee Joints ◽  
Imaging Features ◽  
Processing Techniques ◽  
Induced Changes ◽  
Tissue Ultrastructure

T2 mapping assesses tissue ultrastructure and composition, yet the association of imaging features and tissue functionality is oftentimes unclear. This study aimed to elucidate this association for the posterior cruciate ligament (PCL) across the micro- and macroscale and as a function of loading. Ten human cadaveric knee joints were imaged using a clinical 3.0T scanner and high-resolution morphologic and T2 mapping sequences. Emulating the posterior drawer test, the joints were imaged in the unloaded (δ0) and loaded (δ1) configurations. For the entire PCL, its subregions, and its osseous insertion sites, loading-induced changes were parameterized as summary statistics and texture variables, i.e., entropy, homogeneity, contrast, and variance. Histology confirmed structural integrity. Statistical analysis was based on parametric and non-parametric tests. Mean PCL length (37.8 ± 1.8 mm [δ0]; 44.0 ± 1.6 mm [δ1] [p < 0.01]), mean T2 (35.5 ± 2.0 ms [δ0]; 37.9 ± 1.3 ms [δ1] [p = 0.01]), and mean contrast values (4.0 ± 0.6 [δ0]; 4.9 ± 0.9 [δ1] [p = 0.01]) increased significantly under loading. Other texture features or ligamentous, osseous, and meniscal structures remained unaltered. Beyond providing normative T2 values across various scales and configurations, this study suggests that ligaments can be imaged morphologically and functionally based on joint loading and advanced MRI acquisition and post-processing techniques to assess ligament integrity and functionality in variable diagnostic contexts.

scholarly journals The MRI posterior drawer test to assess posterior cruciate ligament functionality and knee joint laxity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lena Marie Wollschläger ◽  
Karl Ludger Radke ◽  
Justus Schock ◽  
Niklas Kotowski ◽  
David Latz ◽  
...  
Keyword(s):  
Knee Joint ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Joint Laxity ◽  
Knee Joints ◽  
Joint Models ◽  
Human Knee ◽  
Clinical Magnetic Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Therapeutic Decision Making

AbstractClinical Magnetic Resonance Imaging (MRI) of joints is limited to mere morphologic evaluation and fails to directly visualize joint or ligament function. In this controlled laboratory study, we show that knee joint functionality may be quantified in situ and as a function of graded posterior cruciate ligament (PCL)-deficiency by combining MRI and standardized loading. 11 human knee joints underwent MRI under standardized posterior loading in the unloaded and loaded (147 N) configurations and in the intact, partially, and completely PCL-injured conditions. For each specimen, configuration, and condition, 3D joint models were implemented to analyse joint kinematics based on 3D Euclidean vectors and their projections on the Cartesian planes. Manual 2D measurements served as reference. With increasing PCL deficiency, vector projections increased significantly in the anteroposterior dimension under loading and manual measurements demonstrated similar patterns of change. Consequently, if combined with advanced image post-processing, stress MRI is a powerful diagnostic adjunct to evaluate ligament functionality and joint laxity in multiple dimensions and may have a role in differentiating PCL injury patterns, therapeutic decision-making, and treatment monitoring.

scholarly journals Fibromas arising from the posterior cruciate ligament tendon sheath in the bilateral knee joints: Case report

2017 ◽  
Vol 14 (4) ◽  
pp. 544-547
Author(s):  
Nobuyuki Kumahashi ◽  
Suguru Kuwata ◽  
Hiroshi Takuwa ◽  
Soichiro Yamamoto ◽  
Yuji Uchio
Keyword(s):  
Case Report ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Tendon Sheath ◽  
Knee Joints ◽  
Bilateral Knee

scholarly journals The correlation between posterior cruciate ligament buckling sign and meniscofemoral ligaments: A radiological study

2021 ◽  
Vol 32 (2) ◽  
pp. 371-376
Author(s):  
Abdulkadir Polat ◽  
Nihat Acar ◽  
Ahmet Aybar ◽  
Fırat Fidan ◽  
Erdem Özden ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Knee Joints ◽  
Resonance Imaging ◽  
Radiological Study ◽  
The Third ◽  
Meniscofemoral Ligaments ◽  
Significant Difference ◽  
The Mean ◽  
Anterior Cruciate

Objectives: This study aims to investigate the correlation between posterior cruciate ligament (PCL) buckling phenomena and the presence or absence of the anterior meniscofemoral ligament (aMFL). Patients and methods: Between January 2012 and January 2019, magnetic resonance imaging of a total of knee joints of 199 patients (163 males, 16 females; mean age: 31.5±5.3 years; range, 18 to 40 years) were reviewed retrospectively. The patients were divided into four groups. The first group included 32 patients with a ruptured anterior cruciate ligament (ACL) and absent aMFL. The second group included 67 patients with a ruptured ACL and apparent aMFL. The third group included 23 patients with an intact ACL and absent aMFL, and the fourth group included 77 patients with an intact ACL and apparent aMFL. The PCL angle was used to measure the buckling degree of the ligament, as calculated as the angle between two lines drawn through the tibial and femoral central portions of the PCL insertions. We assessed the buckling phenomena of the PCL in ACL-ruptured and ACL-intact knees and examined a possible correlation between the PCL buckling angle and the presence or absence of the aMFL of Humphrey. Results: In the ruptured ACL groups (Groups 1 and 2), the mean PCL buckling angle values were 133.88±6.32 and 104.83±7.34 degrees, respectively. A significant difference was detected between both groups (p=0.026). In the intact ACL groups (Groups 3 and 4), the mean PCL buckling angle values were 143.47±5.96 and 116.77±8.38 degrees, respectively. A significant difference was detected between both groups (p=0.039). No statistically significant difference was observed between Groups 1 and 3 (p=0.13) and between Groups 2 and 4 (p=0.088). Conclusion: The PCL buckling sign is not specific for ACL ruptures, and can be seen frequently in normal knee joints which it is strongly associated with the presence of aMFL of Humphrey.

scholarly journals Quantitative analysis of the ACL and PCL using T1rho and T2 relaxation time mapping: an exploratory, cross-sectional comparison between OA and healthy control knees

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chanuka D. S. Ranmuthu ◽  
James W. MacKay ◽  
Victoria A. Crowe ◽  
Joshua D. Kaggie ◽  
Dimitri A. Kessler ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Repeated Measures ◽  
T2 Mapping ◽  
Cruciate Ligament ◽  
Intraclass Correlation ◽  
Relaxation Times ◽  
Fast Spin Echo ◽  
Human Populations ◽  
Cruciate Ligaments ◽  
T2 Relaxation

Abstract Background Quantitative magnetic resonance imaging (MRI) methods such as T1rho and T2 mapping are sensitive to changes in tissue composition, however their use in cruciate ligament assessment has been limited to studies of asymptomatic populations or patients with posterior cruciate ligament tears only. The aim of this preliminary study was to compare T1rho and T2 relaxation times of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) between subjects with mild-to-moderate knee osteoarthritis (OA) and healthy controls. Methods A single knee of 15 patients with mild-to-moderate knee OA (Kellgren-Lawrence grades 2–3) and of 6 age-matched controls was imaged using a 3.0 T MRI. Three-dimensional (3D) fat-saturated spoiled gradient recalled-echo images were acquired for morphological assessment and T1ρ- and T2-prepared pseudo-steady-state 3D fast spin echo images for compositional assessment of the cruciate ligaments. Manual segmentation of whole ACL and PCL, as well as proximal / middle / distal thirds of both ligaments was carried out by two readers using ITK-SNAP and mean relaxation times were recorded. Variation between thirds of the ligament were assessed using repeated measures ANOVAs and differences in these variations between groups using a Kruskal-Wallis test. Inter- and intra-rater reliability were assessed using intraclass correlation coefficients (ICCs). Results In OA knees, both T1rho and T2 values were significantly higher in the distal ACL when compared to the rest of the ligament with the greatest differences in T1rho (e.g. distal mean = 54.5 ms, proximal = 47.0 ms, p < 0.001). The variation of T2 values within the PCL was lower in OA knees (OA: distal vs middle vs proximal mean = 28.5 ms vs 29.1 ms vs 28.7 ms, p = 0.748; Control: distal vs middle vs proximal mean = 26.4 ms vs 32.7 ms vs 33.3 ms, p = 0.009). ICCs were excellent for the majority of variables. Conclusion T1rho and T2 mapping of the cruciate ligaments is feasible and reliable. Changes within ligaments associated with OA may not be homogeneous. This study is an important step forward in developing a non-invasive, radiological biomarker to assess the ligaments in diseased human populations in-vivo.

The Functional Assessment of the Untreated and the Reconstructed Posterior Cruciate Ligament Deficient Knee

1998 ◽  
Vol 02 (01) ◽  
pp. 27-34
Author(s):  
Robert Wen-Wei Hsu ◽  
Cheng-Kung Cheng ◽  
Yang-Hua Lin
Keyword(s):  
Muscle Strength ◽  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Untreated Group ◽  
Knee Joints ◽  
Knee Extensors ◽  
Functional Evaluation ◽  
Medial Head ◽  
Significant Difference ◽  
Kt 1000

Seventeen patients with rupture of the posterior cruciate ligament (PCL), 7 untreated and 10 having reconstruction of the PCL using the medial head of the gastrocnemius and the attached adductor tendon, were recruited for functional evaluation. The clinical functional status of the knee joint was evaluated in accordance with Hughston's criteria and Lysholm's score. The patients' gaits were analyzed using a three-dimensional electrogoniometer and mats. Muscle strength was assessed via Cybex-340; and a KT-1000 arthrometer was used to measure the laxity of the knee joints. Muscle strength tests showed a significant difference ( p < 0.01) in the knee extensors when the injured side was compared with the noninjured side in the untreated group, while no significant difference existed in reconstructed group. The gait analysis revealed that a significant difference existed over the velocity ( p < 0.05) when the reconstructed group was compared with the untreated group. The KT-1000 arthrometer test demonstrated that the anterior and posterior drawer at a knee flexion of 70 degrees and the posterior tibial sag screen at 90 degrees, differed significantly ( p < 0.01) between injured and noninjured limbs in the untreated group. In the reconstructed group only the anterior drawer presented a significant difference ( p < 0.05) between the injured and noninjured limbs. Using Hughston's and Lysholm's criteria, reconstruction was shown to have improved the knees' functions and scores postoperatively ( p < 0.01). The authors concluded that although the overall clinical results along with dynamic function, stability and strength of the extensor of the knee joints with PCL deficiency, were significantly improved after reconstruction using the medial head of the gastrocnemius together with the adductor tendon, yet, the normal perfect knee functions were still not achieved. A more sophisticated reconstructive procedure needs further investigation.

Isolated Posterior Cruciate Ligament Injuries

1994 ◽  
Vol 13 (3) ◽  
pp. 519-530 ◽  
Author(s):  
James R. Andrews ◽  
John C. Edwards ◽  
Yvonne E. Satterwhite
Keyword(s):  
Posterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Ligament Injuries
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