Skin Movement for Individuals With ACL-Deficient and ACL-Reconstructed Knees

2010 ◽  
Author(s):  
Hongsheng Wang ◽  
Naiquan Nigel Zheng
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Daily Activities ◽  
Joint Motion ◽  
Skin Marker ◽  
Knee Joint Motion ◽  
Anterior Cruciate ◽  
Acl Deficient

The anterior cruciate ligament reconstructed (ACL-R) knees suffer from a higher risk for osteoarthritis (OA) which is the major leading cause of disability[1]. In order to understand the mechanism of knee injury and the development of OA, precise 3-D knee joint motion is often determined by invasive, or radioactive approaches[2]. For studying daily activities like walking which has larger range of motion (ROM), the skin marker-based technique remains the only feasible way[3].

scholarly journals A Case of Posterolateral Corner Injury with Segond Fracture in Association with Anterior Cruciate Ligament Tear on MRI - A Case Report

2021 ◽  
Vol 10 (31) ◽  
pp. 2511-2513
Author(s):  
Amruta Dinesh Varma ◽  
Rajasbala P. Dhande ◽  
Suhasini Pattabiraman ◽  
Rishabh Gupta ◽  
Nagendra Vadlamudi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Posterolateral Corner ◽  
Anterior Cruciate Ligament Tear ◽  
Segond Fracture ◽  
Ligament Tear ◽  
Anterior Cruciate ◽  
Posterolateral Corner Injury

Knee injuries are common in sports and depending on the mechanism of fall, injury of different ligaments can occur. Knee injury mostly involves the anterior cruciate ligament (ACL), and is the most common injury reported on MRI. It can be associated with posterolateral corner (PLC) injury and other osseous injuries, these injuries are rarely reported as they are very complex in structure. A detail knowledge about this complex helps to evaluate the associated ligaments as well. In association with anterior cruciate ligament injuries presence of a Segond fracture indicates occurrence of a concomitant or isolated injury to the posterolateral corner injury. The evaluation of these associated injuries along with anterior cruciate ligament aids in their repair and hence improving the postoperative outcome. Three main components of posterolateral corner are divided into three layers – superficial, middle, and deep. Clinically few tests have been advised to evaluate injury of different structures of knee joint. For example - McMurray's test and Ege's test are used to evaluate meniscus, Lachman test, Anterior drawer test and Pivot Shift Test are performed to evaluate anterior cruciate ligament tear while posterior drawer test is done to evaluate posterior cruciate ligament tear. Availability of special closely coupled extremity coils, high field systems, open system & extremity units have made MRI supplemental to clinical examination and plain radiographs for virtually all suspected disorders of knee. Here, we are presenting a case of MRI of knee injury involving posterolateral corner injury with anterior cruciate ligament tear and Segond fracture. Along with anterior cruciate ligament, medial meniscus, other ligaments and osseous injury are associated as well. The other structures responsible for stabilizing the knee joints are posterolateral corner and meniscus, which when involved may need to be treated simultaneously with anterior cruciate ligament tear, for full re stabilization of knee joint. If any associated fracture is present, it has to be treated simultaneously as well.

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 Effect of Functional Knee Braces on Muscular Contributions to Joint Rotational Stiffness in Anterior Cruciate Ligament–Deficient and –Reconstructed Patients

2019 ◽  
Vol 35 (5) ◽  
pp. 344-352
Author(s):  
Aaron Derouin ◽  
Jim R. Potvin
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Knee Flexion ◽  
Muscle Activation ◽  
Cruciate Ligament ◽  
Rotational Stiffness ◽  
Flexion Extension ◽  
Knee Braces ◽  
Anterior Cruciate ◽  
Acl Deficient

Functional knee braces are frequently prescribed by physicians to ameliorate the function of individuals with anterior cruciate ligament (ACL) injuries. These braces have been shown in the literature to potentially enhance knee stability by augmenting muscle activation patterns and the timing of muscle response to perturbations. However, very few techniques are available in the literature to quantify how those modifications in lower-limb muscle activity influence stability of the knee. The aim of the present study was to quantify the effect of an off-the-shelf functional knee brace on muscle contributions to knee joint rotational stiffness in ACL-deficient and ACL-reconstructed patients. Kinematic, electromyography, and kinetic data were incorporated into an electromyography-driven model of the lower extremity to calculate individual and total muscle contributions to knee joint rotational stiffness about the flexion–extension axis, for 4 independent variables: leg condition (contralateral uninjured, unbraced ACL injured, and braced ACL injured); knee flexion (5°–10°, 20°–25°, and 30°–35°); squat stability condition (stable and unstable); and injury status (ACL deficient and ACL reconstructed). Participants had significantly higher (P < .05,η2 = .018) total knee joint rotational stiffness values while wearing the brace compared with the control leg. A 2-way interaction effect between stability and knee flexion (P < .05,η2 = .040) for total joint rotational stiffness was also found.

KINETIC AND KINEMATIC PERFORMANCE OF THE UNAFFECTED LOWER LIMB DURING STEP DESCENT IN SUBJECTS WITH ANTERIOR CRUCIATE LIGAMENT INJURY

2017 ◽  
Vol 17 (01) ◽  
pp. 1750021 ◽  
Author(s):  
MOHAMMADREZA NEMATOLLAHI ◽  
MOHAMMAD TAGHI KARIMI ◽  
ALI RAFIEE ◽  
FRANCIS FATOYE
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Healthy Subjects ◽  
Cruciate Ligament ◽  
Lower Extremities ◽  
Single Step ◽  
Anterior Cruciate ◽  
Kinetics Of ◽  
Kinematics And Kinetics ◽  
Acl Deficient

The anterior cruciate ligament (ACL) plays a significant role in the dynamics of the knee joint during locomotion. Previous investigations mainly verified kinematics and kinetics of patients with ACL deficiency drawn on the injured leg. Most studies analyzed these patients after reconstruction surgery. The aim of the present study was to scrutinize the kinematics and kinetics of the intact leg of the ACL deficient individuals during a single step descent. 15 ACL deficient individuals (ACLD) and 15 healthy subjects were recruited in this study. They were asked to descent a single step and continue to walk with preferred speed. Kinematics and kinetics of the hip, knee and ankle of both lower extremities were analyzed. Data was divided into step and walking phases. For the step phase, there were significant differences between the two groups in hip ([Formula: see text]), knee ([Formula: see text]) and ankle ([Formula: see text]) joints range of motion between groups. Velocity of the step descent phase was higher in ACLD subjects in comparison to normal group ([Formula: see text]). For the walking phase, knee joint range of motion in anteroposterior plane was lower in patients group ([Formula: see text]). The stride length in patients group was shorter than that of healthy subjects ([Formula: see text]). The sound side of the ACLD subjects demonstrated different patterns as compared to healthy control group. Both lower extremities may experience early degenerative changes. Therefore, it is recommended that both lower extremities should be assessed in ACLD patients.

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.

There is an Association of Synovial Interleukin-6 Levels With Chondral Damage in Anterior Cruciate Ligament–Deficient Knees

2021 ◽  
pp. 155633162199200
Author(s):  
Ravi Gupta ◽  
Anil Kapoor ◽  
Sourabh Khatri ◽  
Dinesh Sandal ◽  
Gladson David Masih
Keyword(s):  
Anterior Cruciate Ligament ◽  
Synovial Fluid ◽  
Acl Reconstruction ◽  
Inflammatory Cytokines ◽  
Interleukin 6 ◽  
Cruciate Ligament ◽  
Interleukin 1 ◽  
Chondral Damage ◽  
Anterior Cruciate ◽  
Acl Deficient

Background: Osteoarthritis (OA) in the anterior cruciate ligament (ACL)–deficient knee is seen in approximately 50% of affected patients. Possible causes include biochemical or biomechanical changes. Purpose: We sought to study the correlation between inflammatory cytokines and chondral damage in ACL-deficient knees. Methods: Seventy-six male patients who underwent ACL reconstruction were enrolled in a cross-sectional study. Synovial fluid was aspirated before surgery and analyzed for levels of the inflammatory cytokines tumor necrosis factor-α, interleukin-1 (IL-1), and interleukin-6 (IL-6). At the time of ACL reconstruction, the severity of chondral damage was documented as described by the Outerbridge classification. Results: Patients with grade 2 or higher chondral damage were observed to have elevated IL-6 levels when compared to patients who had no chondral damage. Interleukin-6 levels had no correlation with the duration of injury. Conclusion: Elevated levels of IL-6 in synovial fluid were associated with chondral damage in ACL-deficient knees. Further study is warranted to determine whether inflammatory cytokines contribute to the development of OA of the knee after ACL injury.

scholarly journals Nonsurgical Management of an Anterior Cruciate Ligament-Deficient Knee in a Women's Soccer Player: A Validation Clinical Case Report

2017 ◽  
Vol 52 (11) ◽  
pp. 1079-1083
Author(s):  
Courtney E. Gray ◽  
Chris Hummel ◽  
Todd Lazenby
Keyword(s):  
Randomized Controlled Trial ◽  
Anterior Cruciate Ligament ◽  
Case Report ◽  
Soccer Player ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Randomized Controlled ◽  
Anterior Cruciate ◽  
Acl Deficient

Background:  A collegiate women's soccer player sustained an isolated anterior cruciate ligament (ACL) tear and expressed a desire to continue her season without surgical intervention. Design:  Case report. Intervention(s):  Using the results of a randomized controlled trial and published clinical guidelines, the clinicians classified the patient as an ACL-deficient coper. The patient completed her soccer season without incident, consistent with the findings of the established clinical guidelines. However, 6 months later, she sustained a meniscal tear, which was not unexpected given that 22% of ACL-deficient copers in the randomized controlled trial incurred a meniscal tear within 24 months of ACL injury. Conclusion:  The external evidence was helpful in making informed clinical decisions regarding patient care.

scholarly journals Magnetic Tracking: A Novel Method of Assessing Anterior Cruciate Ligament Deficiency

2006 ◽  
Vol 88 (1) ◽  
pp. 16-17 ◽  
Author(s):  
RK Kundra ◽  
JD Moorehead ◽  
N Barton-Hanson ◽  
SC Montgomery
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tracking System ◽  
Cruciate Ligament ◽  
Magnetic Tracking ◽  
Lachman Test ◽  
Acl Deficiency ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tracking Device ◽  
Acl Deficient

INTRODUCTION The Lachman test is commonly performed as part of the routine assessment of patients with suspected anterior cruciate ligament (ACL) deficiency. A major drawback is its reliance on the clinician's subjective judgement of movement. The aim of this study was to quantify Lachman movement using a magnetic tracking device thereby providing a more accurate objective measure of movement. PATIENTS AND METHODS Ten patients aged 21–51 years were assessed as having unilateral ACL deficiency with conventional clinical tests. These patients were then re-assessed using a Polhemus Fastrak™ magnetic tracking device. RESULTS The mean anterior tibial displacement was 5.6 mm (SD = 2.5) for the normal knees and 10.2 mm (SD = 4.2) for the ACL-deficient knees. This gave an 82% increase in anterior tibial displacement for the ACL deficient knees. This was shown to be highly significant with P = 0.005. CONCLUSIONS The magnetic tracking system offers an objective quantification of displacements during the Lachman test. It is convenient, non-invasive and comfortable for the patient and is, therefore, ideally suited for use as an investigative tool.

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