MRI EVALUATION OF MENISCAL AND LIGAMENTOUS INJURIES OF KNEE IN CORRELATION WITH ARTHROSCOPY

Background - In knee joint injuries, clinical examination, radiographs and CT scan is not enough to diagnose many internal derangements of this joint. MR studies are required to assess the injuries of the menisci, cartilage ligaments or bone. A cross-sectional, Materials and methodsanalytical–observational study was conducted at the Department of Radiodiagnosis. A total of 65 patients with clinical suspicion of knee ligament injury and were referred for MRI were examined, 41 patients were males and 24 were females, their ages ranging from18 to 60 yrs. ACL Resultstear was the most common lesion, presented in 53.84 % cases out of which 29.32% cases were partial tear and 24.62% cases were complete tear. Medial Meniscus tear was the second most common lesion. 25% cases presented with combined injuries and 75% cases presented with isolated injuries. The predominant pattern was ACL and MM tears, followed by ACL tear and LM tears. Correlation between MRI and arthroscopic ndings are statistically signicant with (88%) of the cases showed good correlation between MRI and arthroscopic ndings. The study Conclusionsrevealed the ability of MRI in evaluation of the various internal derangements, including their detection, types (partial/complete tear) localization, characterization and assessment of extent of damage and the strength of correlation between MRI and arthroscopic helped the orthopaedic surgeons as a conservative approach was indicated in partial tears while a repair/reconstruction was indicated in a complete tear.

Effectiveness of an Unexpected Disturbance Program in the Early Stage of Rehabilitation in Athletes With Unilateral Knee Ligament Injury

Context: Sensorimotor, proprioceptive, and neuromuscular programs are critical for the successful rehabilitation of injured athletes, and these decrease reinjury rates. Objective: To investigate the effects of an unexpected disturbance program (UDP) on balance and unilateral strength metrics in athletes with unilateral knee ligament injury. Design: A 3-week parallel-group experimental design consisting of 9 rehabilitation sessions. Setting: National Sports Institute. Participants: Twenty-one national-level athletes (age 21.4 [4.4] y, body mass 63.9 [10.8] kg, height 169.0 [10.2] cm) who had sustained a unilateral knee ligament injury. Intervention: An UDP program designed to evoke rapid sensorimotor responses was compared with traditional training and a nonexercise control group. Main Outcome Measures: Unilateral total, anteroposterior, and mediolateral sway with eyes open and closed and unilateral isometric strength. Results: Traditional exercises tended to outperform the UDP when unilateral balance testing was performed with eyes open; however, balance improvement following UDP tended to be greater in the eyes-closed condition. Significant strength gains in both the injured and uninjured legs were only observed following the UDP. This increase in unilateral isometric strength was 23.4 and 35.1 kg greater than the strength improvements seen in the traditional rehabilitation and control groups (P < .05). Conclusions: UDP could improve neural aspects of rehabilitation to improve rehabilitation outcomes by improving strength, sensorimotor function, and proprioception. Given the complementary adaptations, an UDP could provide an effective adjunct to traditional rehabilitation protocols and improve return-to-play outcomes.

Effects of Different Combinations of Concentric and Eccentric Resistance Training Programs on Traditional and Alternative Hamstrings-to-Quadriceps Ratios

Resistance training is often recommended for combined increases in traditional and alternative hamstrings-to-quadriceps (H:Q) ratios in order to reduce knee strength imbalance and associated hamstrings and knee ligament injury risk. The aim of this study was to investigate the effect of different concentric and eccentric resistance training programs on traditional and alternative H:Q ratios. Forty male volunteers were assigned to one of 4 groups: concentric quadriceps and concentric hamstrings (CON/CON, n = 10), eccentric quadriceps and eccentric hamstrings (ECC/ECC, n = 10), concentric quadriceps and eccentric hamstrings (CON/ECC, n = 10), or no training (control (CNTRL), n = 10). Traditional conventional (CR) and functional (FR), alternative rate of torque development (RTD), muscle size (MS), and muscle activation (MA) H:Q ratios were measured before and after six weeks of unilateral nondominant knee extension–flexion resistance training performed on an isokinetic dynamometer. The ECC/ECC training significantly increased FR (pre = 0.75 ± 0.11; post = 0.85 ± 0.15), whereas the lack of training (CNTRL) decreased the RTD H:Q ratio (pre = 1.10 ± 0.67; post = 0.73 ± 0.33). There were no differences between groups for the other traditional and alternative ratios following resistance training protocols. These findings suggest eccentric exercise for quadriceps and hamstrings as the most beneficial training program for inducing increases in the traditional FR. However, different resistance training strategies may be needed to also elicit increases in the alternative RTD, MS, and MA H:Q ratios for fully restoring muscle balance and reducing potential hamstrings and knee ligament injury risk.

Biomechanical Differences in Knee Valgus Angles in Collegiate Female Athletes Participating in Different Sports

Background: Dynamic knee valgum is a major risk factor in ligamentous injuries of the knee. Different sports have higher rates of knee ligament injury than others and females experience knee non-contact ligament injuries at higher rates than their male counterparts. Objectives: The purpose of this study was to investigate the lower extremity biomechanics of genu valgum in female collegiate athletes of various sports while performing a drop jump test. This information may provide those designing individualized prevention programs assistance in reducing risk of knee ligamentous injury during jumping tasks. Methods: Current members of Idaho State University’s women’s basketball, soccer, and softball teams were evaluated for this study. Thirty-seven athletes participated. Motion capture reflective markers were placed bilaterally on the lower extremities to allow for analysis of knee biomechanics during a double-leg drop jump test. The angles of knee valgum in the frontal plane were calculated and analyzed between sport groups. Results: Female athletes of different sports displayed statistically significant differences in knee angles for both right, and left knees. Post hoc analysis with a Bonferroni adjustment revealed that basketball players utilized a more valgus right knee angle compared to both soccer and softball players and a more varus left knee angle compared with softball players. Conclusions: Our study suggests that collegiate-level female basketball players have an increased risk of right leg non-contact knee ligament injury during jump landing maneuvers when compared to collegiate level softball and soccer players due to increased knee valgus movements during the drop jump test. Collegiate-level female basketball players may benefit from biomechanical exercise interventions designed to decrease right knee valgus moments in jumping and landing to decrease their risk of injury.