scholarly journals The Relationship between Anterior Cruciate Ligament Injury and Osteoarthritis of the Knee

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
David Simon ◽  
Randy Mascarenhas ◽  
Bryan M. Saltzman ◽  
Meaghan Rollins ◽  
Bernard R. Bach ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Surgical Reconstruction ◽  
Ligament Injury ◽  
Tibial Rotation ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
The Relationship

Anterior cruciate ligament (ACL) tears are a common injury, particularly in the athletic and youth populations. The known association between ACL injury and subsequent osteoarthritis (OA) of the knee merits a more in-depth understanding of the relationship between the ACL-injured knee and osteoarthritis. ACL injury, especially with concomitant meniscal or other ligamentous pathology, predisposes the knee to an increased risk of osteoarthritis. ACL insufficiency results in deterioration of the normal physiologic knee bending culminating in increased anterior tibial translation and increased internal tibial rotation. This leads to increased mean contact stresses in the posterior medial and lateral compartments under anterior and rotational loading. However, surgical reconstruction of the ACL has not been shown to reduce the risk of future OA development back to baseline and has variability based on operative factors of graft choice, timing of surgery, presence of meniscal and chondral abnormalities, and surgical technique. Known strategies to prevent OA development are applicable to patients with ACL deficiency or after ACL reconstruction and include weight management, avoidance of excessive musculoskeletal loading, and strength training. Reconstruction of the ACL does not necessarily prevent osteoarthritis in many of these patients and may depend on several external variables.

scholarly journals Is restricted hip movement a risk factor for anterior cruciate ligament injury?

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901879952
Author(s):  
Naoki Nakano ◽  
Jonathan Bartlett ◽  
Vikas Khanduja
Keyword(s):  
Anterior Cruciate Ligament ◽  
Risk Factor ◽  
Clinical Studies ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Radiological Studies

Restricted hip movement along with femoroacetabular impingement (FAI) has been reported to be an important risk factor in anterior cruciate ligament (ACL) injury. We performed a literature review assessing the evidence that FAI, or restricted hip movement, contributes to the likelihood of sustaining an ACL injury to provide an evidence-based and comprehensive update on the relationship between these pathologies. Studies were divided into three categories: clinical studies, radiological studies and cadaveric studies. Clinical studies primarily assessed the limitations to hip movement in patients with ACL injury, and numerous studies of this kind have demonstrated a relationship between restricted movement and ACL injury. Radiological studies have been able to demonstrate a higher number of bony hip abnormalities in patients with ACL injury. However, due to variable results within these studies, it is unclear which kinds of bony abnormality are specifically associated with an increased risk of ACL injury. Cadaveric studies have demonstrated that peak ACL relative strain was inversely related to the range of internal rotation of the femur, thus providing a potential mechanism for this relationship. In conclusion, clinical and radiological studies have established a correlation between restricted hip and ACL injury, but have been unable to demonstrate an increased risk of future ACL injury in individuals with restricted hip movement. Future prospective cohort studies are necessary to confirm this. Additionally, these findings highlight the need for a thorough clinical assessment of the hip when assessing patients with an ACL injury.

Does the Curved Nature of the Tibia Influence the Non-Contact ACL Injury?

2012 ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Javad Hashemi ◽  
James R. Slauterbeck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Medial Compartment ◽  
Ligament Injury ◽  
Increased Risk ◽  
Anterior Cruciate ◽  
Matlab Programming

The geometry of the tibial plateau and the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of curved profile of the medial compartment of the tibia in a sagittal plane as a critical risk factor for the anterior cruciate ligament (ACL) injuries. The curvature of the mid-medial compartment of Tibia in 40 uninjured controls (21 women and 19 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and in-house matlab programming. We hypothesized that the Individuals with a less curved profile in the medial compartment of the tibia are at increased risk of suffering an anterior cruciate ligament injury compared to those with larger curved profiles. Based on t-tests, we established that the uninjured controls had larger curvature (p<0.05) compared to the injured cases. Biomechanically speaking a larger curvature of the tibia could prevent excessive sliding movement of femur with respect to the tibia, and thus could reduce the ACL strain. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of this curved profile of tibia in the risk of ACL injury.

scholarly journals Risk Factors for Anterior Cruciate Ligament Injury: literature Review: مخاطر الإصابة بالرباط الصليبي الأمامي: مراجعة أدبية

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Suleiman Ali Mansi
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Joint Stability ◽  
Increased Risk ◽  
Potential Risk Factors ◽  
Anterior Cruciate

  The Anterior cruciate ligament (ACL) plays an important role in maintaining knee-joint stability. Most ACL injures (approximately 65%) are due to a non-contact mechanism during physical activities, particularly in sports involving a landing from a jump, pivoting on the leg, rapid deceleration and cutting maneuvers. The average injury of ACL rates is still high for both professional and recreational athletes in particular between the group ages of 15 to 25 year old. The purpose of this article was to review and analysis the causes and potential risk factors for the ACL injury. Several anatomic and neuromuscular risk factors are associated with increased risk of suffering ACL injury, such as shoe-surface interaction, quadriceps angle, knee-joint laxity, genu varum of knee, and body composition. These risk factors most likely act in combination to influence the risk of ACL injury. Therefore, these factors should be considered when designing training programs, competitions, and implementing ACL injury prevention programs.

scholarly journals Collagen XII Deficiency Increases the Risk of Anterior Cruciate Ligament Injury in Mice

2021 ◽  
Vol 10 (18) ◽  
pp. 4051
Author(s):  
Shin Fukusato ◽  
Masashi Nagao ◽  
Kei Fujihara ◽  
Taiju Yoneda ◽  
Kiyotaka Arai ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Mrna Expression ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Acl Rupture ◽  
Surgical Reconstruction ◽  
Ligament Injury ◽  
Wild Type ◽  
Abnormal Gait ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) rupture is a common knee injury for athletes. Although surgical reconstruction is recommended for the treatment of ACL ruptures, 100% functional recovery is unlikely. Therefore, the discovery of risk factors for ACL ruptures may prevent injury. Several studies have reported an association between polymorphisms of the collagen XII gene COL12A1 and ACL rupture. Collagen XII is highly expressed in tendons and ligaments and regulates tissue structure and mechanical property. Therefore, we hypothesized that collagen XII deficiency may cause ACL injury. To elucidate the influence of collagen XII deficiency on ACL, we analyzed a mouse model deficient for Col12a1. Four- to 19-week-old male Col12a1-/- and wild-type control mice were used for gait analysis; histological and immunofluorescent analysis of collagen XII, and real-time RT-PCR evaluation of Col12a1 mRNA expression. The Col12a1-/- mice showed an abnormal gait with an approximately 2.7-fold increase in step angle, suggesting altered step alignment. Col12a1-/- mice displayed 20–60% ACL discontinuities, but 0% discontinuity in the posterior cruciate ligament. No discontinuities in knee ligaments were found in wild-type mice. Collagen XII mRNA expression in the ACL tended to decrease with aging. Our study demonstrates for the first time that collagen XII deficiency increases the risk of ACL injury.

scholarly journals The influence of sex and BMI on cartilage metabolism biomarkers in patients after anterior cruciate ligament injury and reconstruction.

2021 ◽  
Author(s):  
Kazandra M. Rodriguez ◽  
Michael T. Curran ◽  
Riann M. Palmieri-Smith
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Serum Levels ◽  
Ligament Injury ◽  
Before And After ◽  
Anterior Cruciate ◽  
The Relationship ◽  
Return To Activity

Abstract Context: Serum biomarkers may allow for early identification of post-traumatic osteoarthritis after anterior cruciate ligament (ACL) injury and reconstruction. Homeostasis of matrix-metalloproteinase-3 (MMP-3) and type II collagen turnover (C2C:CPII) biomarkers are believed to be compromised in individuals with ACL injury, yet the influence of sex, BMI, and age on these biomarkers before and after ACL reconstruction remains unknown. Objective: To determine the relationship of sex, BMI, and age on serum levels of MMP-3 and C2C:CPII before and after ACL reconstruction. Design: Descriptive Laboratory Study Setting: Laboratory. Patients: 32 (18F,14M) ACL-injured subjects participated in this study. Main Outcome Measures: Demographic variables and blood samples were collected prior to surgery and at the time of return to activity. Serum was extracted from the blood and assays were used to quantify MMP-3 and C2C:CPII. Generalized linear mixed-effects regression models were used to assess the relationship between sex, BMI, time, age, and subject on the outcome variables. Results: A significant time-sex interaction was identified for MMP-3 levels (P=0.021), whereby MMP-3 levels were higher in males at return to activity (Males:2.71±0.59ng/mL; Females:1.92±0.60ng/mL; P=0.017). Males also had higher MMP-3 levels at return to activity when compared to pre-surgery levels (P=0.009). A main effect for age demonstrated that older age was associated with higher MMP-3 levels. No significant main or interaction effects were noted for C2C:CPII levels. Conclusions: MMP-3 serum levels may be upregulated following ACL reconstruction, particularly in men, which may have deleterious consequences for the cartilage matrix. Sex, BMI, and time did not influence C2C:CPII ratios but further research with larger sample sizes are needed to confirm these findings.

Influence of Tibial Eminence Size on the ACL Injury

2011 ◽  
Author(s):  
Ariful I. Bhuiyan ◽  
Javad Hashemi ◽  
Ryan E. Breighner ◽  
James R. Slauterbeck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Ligament Injury ◽  
Tibial Eminence ◽  
Increased Risk ◽  
Anterior Cruciate

The geometry of the tibial plateau as well as the femoral condyles are emerging as key parameters to be studied as anterior cruciate ligament (ACL) injury risk factors. In this paper, we study the role of tibial eminence size as a potentially important characteristic of the tibial plateau in loading and or protecting the ACL from injury. The volume of Tibial eminence in 52 uninjured controls (32 women and 20 men) and 44 anterior cruciate ligament-injured cases (23 women and 21 men) were measured using magnetic resonance images and 3-d image reconstruction using commercial software Analyze 9.0. We hypothesized that the Individuals with a small tibial eminence are at increased risk of suffering an anterior cruciate ligament injury compared with those with larger tibial eminences. Based on t-tests, we established that the uninjured controls had larger tibial eminences (p<0.05) compared with the injured cases. Biomechanically speaking a larger tibial eminence could prevent excessive medio-lateral movement of femur with respect to the tibia. A larger eminence could also protect the knee from large magnitude rotational movements. We suggest that future studies are needed to confirm this relationship and to evaluate the potential role of the tibial eminence size in the risk of ACL injury.

Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S21.2-S22
Author(s):  
Ryan Moran
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
Ligament Injury ◽  
Jump Landing ◽  
Eyes Closed ◽  
Eyes Open ◽  
Anterior Cruciate ◽  
The Relationship

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

A Novel Graft Fixation Technique for Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Grafts

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Guoan Li ◽  
Ali Hosseini ◽  
Hemanth Gadikota ◽  
Thomas Gill
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Reconstruction Technique ◽  
Tibial Rotation ◽  
Pullout Strength ◽  
Anterior Tibial ◽  
Anterior Cruciate ◽  
Tibial Translation ◽  
Intact Knee

This study evaluated the biomechanical efficacy of single-tunnel double-bundle anterior cruciate ligament (ACL) reconstruction technique. The graft construct is achieved using a novel fixation device that splits an ACL (SPACL) graft into two bundles, recreating the anteromedial (AM) and posterolateral (PL) bundles for ACL reconstruction. A pullout strength test of the SPACL was performed using a 7-mm bovine digital extensor tendon graft. The capability in restoration of knee kinematics after SPACL reconstruction was investigated using cadaveric human knees on a robotic testing system under an anterior tibial load of 134 N and a simulated quadriceps load of 400 N. The data indicated that the SPACL graft has a pullout strength of 823.7±172.3 N. Under the 134 N anterior tibial load, the anteroposterior joint laxity had increased constraint using the SPACL reconstruction but not significantly (p > 0.05) at all selected flexion angles. Under the 400 N quadriceps load, no significant differences were observed between the anterior tibial translation of intact knee and SPACL conditions at all selected flexion angles, but the SPACL graft induced a significant increase in external tibial rotation compared to the intact knee condition at all selected flexion angles with a maximal external rotation of −3.20 deg ±3.6 deg at 90 deg flexion. These data showed that the SPACL technique is equivalent or superior to existing ACL reconstruction techniques in restoration of knee laxity and kinematics. The new SPACL reconstruction technique could provide a valuable alternation to contemporary ACL reconstruction surgery by more closely recreating native ACL kinematics.

scholarly journals A Comparison of Knee Abduction Angles Measured by a 3D Anatomic Coordinate System Versus Videographic Analysis: Implications for Anterior Cruciate Ligament Injury

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711881983 ◽  
Author(s):  
Zoë A. Englander ◽  
Hattie C. Cutcliffe ◽  
Gangadhar M. Utturkar ◽  
William E. Garrett ◽  
Charles E. Spritzer ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Coordinate System ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Magnetic Resonance Images ◽  
Coronal Plane ◽  
Ligament Injury ◽  
Abduction Angle ◽  
Knee Abduction ◽  
Anterior Cruciate

Background: Knee positions involved in noncontact anterior cruciate ligament (ACL) injury have been studied via analysis of injury videos. Positions of high ACL strain have been identified in vivo. These methods have supported different hypotheses regarding the role of knee abduction in ACL injury. Purpose/Hypothesis: The purpose of this study was to compare knee abduction angles measured by 2 methods: using a 3-dimensional (3D) coordinate system based on anatomic features of the bones versus simulated 2-dimensional (2D) videographic analysis. We hypothesized that knee abduction angles measured in a 2D videographic analysis would differ from those measured from 3D bone anatomic features and that videographic knee abduction angles would depend on flexion angle and on the position of the camera relative to the patient. Study Design: Descriptive laboratory study. Methods: Models of the femur and tibia were created from magnetic resonance images of 8 healthy male participants. The models were positioned to match biplanar fluoroscopic images obtained as participants posed in lunges of varying flexion angles (FLAs). Knee abduction angle was calculated from the positioned models in 2 ways: (1) varus-valgus angle (VVA), defined as the angle between the long axis of the tibia and the femoral transepicondylar axis by use of a 3D anatomic coordinate system; and (2) coronal plane angle (CPA), defined as the angle between the long axis of the tibia and the long axis of the femur projected onto the tibial coronal plane to simulate a 2D videographic analysis. We then simulated how changing the position of the camera relative to the participant would affect knee abduction angles. Results: During flexion, when CPA was calculated from a purely anterior or posterior view of the joint—an ideal scenario for measuring knee abduction from 2D videographic analysis—CPA was significantly different from VVA ( P < .0001). CPA also varied substantially with the position of the camera relative to the participant. Conclusion: How closely CPA (derived from 2D videographic analysis) relates to VVA (derived from a 3D anatomic coordinate system) depends on FLA and camera orientation. Clinical Relevance: This study provides a novel comparison of knee abduction angles measured from 2D videographic analysis and those measured within a 3D anatomic coordinate system. Consideration of these findings is important when interpreting 2D videographic data regarding knee abduction angle in ACL injury.

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