scholarly journals Comprehensive Assessment of Medial Knee Joint Instability by Valgus Stress MRI

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1433
Author(s):  
Malin Ciba ◽  
Eva-Maria Winkelmeyer ◽  
Justus Schock ◽  
Philipp Schad ◽  
Niklas Kotowski ◽  
...  
Keyword(s):  
Knee Joint ◽  
Joint Instability ◽  
Cruciate Ligament ◽  
Medial Compartment ◽  
Joint Models ◽  
Valgus Stress ◽  
Joint Injury ◽  
Medial Knee ◽  
Anterior Cruciate ◽  
Therapeutic Decision Making

Standard clinical MRI techniques provide morphologic insights into knee joint pathologies, yet do not allow evaluation of ligament functionality or joint instability. We aimed to study valgus stress MRI, combined with sophisticated image post-processing, in a graded model of medial knee joint injury. To this end, eleven human cadaveric knee joint specimens were subjected to sequential injuries to the superficial medial collateral ligament (sMCL) and the anterior cruciate ligament (ACL). Specimens were imaged in 30° of flexion in the unloaded and loaded configurations (15 kp) and in the intact, partially sMCL-deficient, completely sMCL-deficient, and sMCL- and ACL-deficient conditions using morphologic sequences and a dedicated pressure-controlled loading device. Based on manual segmentations, sophisticated 3D joint models were generated to compute subchondral cortical distances for each condition and configuration. Statistical analysis included appropriate parametric tests. The medial compartment opened gradually as a function of loading and injury, especially anteriorly. Corresponding manual reference measurements by two readers confirmed these findings. Once validated in clinical trials, valgus stress MRI may comprehensively quantify medial compartment opening as a functional imaging surrogate of medial knee joint instability and qualify as an adjunct diagnostic tool in the differential diagnosis, therapeutic decision-making, and monitoring of treatment outcomes.

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.

Application of Synthetic Substitute Materials on Reconstruction of Anterior Cruciate Ligament of Knee Joint in Exercise-Induced Injury

2014 ◽  
Vol 977 ◽  
pp. 30-33
Author(s):  
Xiao Liang Miao ◽  
Lei Zhang ◽  
Hong Mei Zhuang ◽  
Zhi Qiang Zhao
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Injury Severity ◽  
Cruciate Ligament ◽  
Joint Injury ◽  
Tissue Allograft ◽  
Knee Joint Injury ◽  
Anterior Cruciate ◽  
Exercise Induced ◽  
And Function

Exercise training or competition in anterior cruciate ligament of knee joint injury, autologous tissue, allograft materials, artificial materials and tissue engineering ACL repair and reconstruction is often used. These materials can repair and reconstruction of anterior cruciate ligament, the choice of materials involves many factors such as stability of complications after anterior cruciate ligament reconstruction and postoperative. Because of the complexity of anterior cruciate ligament of knee joint structure and function, finally to many factors combined with the site of injury, injury severity and the patient's own state cross ligament repair and reconstruction of knee joint replacement materials.

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 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.

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