scholarly journals Short-Term Outcome of Multi-Ligament Knee Injury among Sudanese Patients

2019 ◽  
Vol 7 (9) ◽  
pp. 1486-1493 ◽  
Author(s):  
Amin Ahmed Ali ◽  
Mohamed Babiker Abdelwahab
Keyword(s):  
Functional Outcome ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
The Body ◽  
University Hospital ◽  
Collateral Ligament ◽  
Term Outcome ◽  
Knee Ligaments ◽  
Excellent Outcome

BACKGROUND: Multi-ligament knee injury is the state of having two or more of the major knee ligaments, namely: the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the posteromedial corner (PMC), and the posterolateral corner (PLC). The knee is a hinge joint; this dictates two direction movements on the y-axis plane. The knee joints carry the weight load of the body uniquely. The role of the knee ligaments is not conserved only to maintain knee in a rigid position while standing, but also orchestrates the biomechanics of knee motion in harmony. Multi-ligament knee injury is very rare (incidence < 10:10,000 of trauma cases). Patients with multiple ligaments injuries of the knee become disabled for a long period. This disability rises from the pain and stiffness of the knee joint. A disability that might be associated with increased frequencies of sick leave from work, or much more dire consequences, such as quitting a job or being relieved of duty. AIM: To assess the functional outcome of the knee of patients with a multi-ligament knee injury after treatment using a standard scoring system and to determine the recovery rates of each treatment option to a multi-ligament knee injury. METHODS: it is a cross-sectional study conducted from January 2018 to January 2019. All patients with multi-ligament knee injuries that were diagnosed by MRI, and underwent reconstruction surgeries or on the waiting list, at Ribat University Hospital and Alyaa Specialized Hospital, Alkuwiti specialised hospital, and Haj Alsafi Hospital for the past 2 years were included. Lyshlome knee scoring scale was used to assess the functional outcome of each patient. RESULTS: 24 patients were enrolled in this study (16 had reconstruction surgery, 8 did not). 3 had excellent outcome (LKSS = 95 – 100), 8 of them had good score (LKSS = 84-94), 5 had fair outcome (LKSS = 65-83). All those who did not have reconstruction had a poor score (LKSS < 64). CONCLUSION: Reconstruction of multi-ligament knee injury shows a good outcome than it was left alone. Post-operative physiotherapy increases the potential of reconstruction. While our data is limited because of the rare condition, we plan to expand our study area to include a larger sample size. We also recommend extending the post-operative physiotherapy to improve the outcome of a multi-ligament knee injury.

scholarly journals The Role of Magnetic Resonance Imaging in Traumatic Knee Injury

2020 ◽  
Vol 5 (1) ◽  
pp. 53-61
Author(s):  
Madan Thapa ◽  
Subash Thapa ◽  
Pramod Kumar Chhetri
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Knee Injury ◽  
Wide Spectrum ◽  
Cruciate Ligament ◽  
Lateral Meniscus ◽  
Lateral Collateral Ligament ◽  
Bone Bruise ◽  
Resonance Imaging ◽  
Collateral Ligament

Introduction: Magnetic Resonance Imaging (MRI) as a non-invasive modality plays a vital role in assessment of a wide spectrum of internal knee derangements. This study focuses on the commonest anatomical derangement and reveals the importance of MRI to characterize the pattern of derangement in the assessment of the patient with knee injury. Methods: This is the hospital based prospective study conducted among 65 patients referred to department of radiology with first presentation of knee injury during two years period from August, 2013 to August, 2015. Patient fulfilling the inclusion criteria underwent Magnetic Resonance Imaging knee in SIEMENS MAGNETOM C 0.35 Tesla MRI machine, after taking written informed consent. Descriptive analysis of data was analyzed using SPSS 20.0 program Result: Of the total 65 patients with knee injury, Sport injuries were the most common mode of knee injury. 63 cases with trauma had findings on MRI. Most of the cases presented with joint effusion (59 cases). Anterior Cruciate Ligament (ACL) tear is the commonest injury (37 cases) during knee trauma followed by Medial Collateral Ligament (MCL), Medial Meniscus, Posterior Cruciate Ligament (PCL), Lateral Meniscus and Lateral Collateral Ligament(LCL) injuries. Conclusion: MRI as a high-contrast soft-tissue imaging technique can be used as a noninvasive modality to assess a wide spectrum of internal knee derangements in a patient with knee injury. Specific pattern of bone bruise can guide us to narrow our diagnosis.

Design and Development of an Instrumented Knee Joint for Quantifying Ligament Displacements

2021 ◽  
Author(s):  
Lei Cui ◽  
Brody Dale ◽  
Garry Allison ◽  
Min Li
Keyword(s):  
Knee Joint ◽  
Rapid Prototyping ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Published Data ◽  
Collateral Ligament ◽  
Knee Ligaments ◽  
Leg Flexion ◽  
Anterior Cruciate ◽  
Four Bar Linkage

Abstract Recently robotic assistive leg exoskeletons have gained popularity because an increased number of people crave for powered devices to run faster and longer or carry heavier loads. However, these powered devices have the potential to impair knee ligaments. This work was aimed to develop an instrumented knee joint via rapid prototyping that measures the displacements of the four major knee ligaments\textemdash the anterior cruciate ligament (ACL), posterior crucial ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL)\textemdash to quantify the strain experienced by these ligaments. The knee model consists of a femur, lateral and medial menisci, and a tibia-fibula, which were printed from 3D imaging scans. Non-stretchable cords served as main fiber bundles of the ligaments with their desired stiffnesses provided by springs. The displacement of each cord was obtained via a rotary encoder mechanism, and the leg flexion angle was acquired via a closed-loop four-bar linkage of a diamond shape. The displacements were corroborated by published data, demonstrating the profiles of the displacement curves agreed with known results. The paper shows the feasibility of developing a subject-specific knee joint via rapid prototyping that is capable of quantifying the ligament strain via rapid prototyping.

Development and Assessment of Novel Multiligament Knee Injury Reconstruction Graft Constructs and Techniques

2020 ◽  
Author(s):  
James L. Cook ◽  
Cristi R. Cook ◽  
Chantelle C. Bozynski ◽  
Will A. Bezold ◽  
James P. Stannard
Keyword(s):  
Knee Injury ◽  
Cruciate Ligament ◽  
Surgical Techniques ◽  
Lateral Collateral Ligament ◽  
Surgical Reconstruction ◽  
Collateral Ligament ◽  
Element Analysis ◽  
Posterior Oblique Ligament ◽  
Computed Tomographic ◽  
Multiligament Knee Injury

AbstractMultiligament knee injury (MLKI) typically requires surgical reconstruction to achieve the optimal outcomes for patients. Revision and failure rates after surgical reconstruction for MLKI can be as high as 40%, suggesting the need for improvements in graft constructs and implantation techniques. This study assessed novel graft constructs and surgical implantation and fixation techniques for anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), posterior medial corner (PMC), and posterior lateral corner (PLC) reconstruction. Study objectives were (1) to describe each construct and technique in detail, and (2) to optimize MLKI reconstruction surgical techniques using these constructs so as to consistently implant grafts in correct anatomical locations while preserving bone stock and minimizing overlap. Cadaveric knees (n = 3) were instrumented to perform arthroscopic-assisted and open surgical creation of sockets and tunnels for all components of MLKI reconstruction using our novel techniques. Sockets and tunnels with potential for overlap were identified and assessed to measure the minimum distances between them using gross, computed tomographic, and finite element analysis-based measurements. Percentage of bone volume spared for each knee was also calculated. Femoral PLC-lateral collateral ligament and femoral PMC sockets, as well as tibial PCL and tibial PMC posterior oblique ligament sockets, were at high risk for overlap. Femoral ACL and femoral PLC lateral collateral ligament sockets and tibial popliteal tendon and tibial posterior oblique ligament sockets were at moderate risk for overlap. However, with careful planning based on awareness of at-risk MLKI graft combinations in conjunction with protection of the socket/tunnel and trajectory adjustment using fluoroscopic guidance, the novel constructs and techniques allow for consistent surgical reconstruction of all major ligaments in MLKIs such that socket and tunnel overlap can be consistently avoided. As such, the potential advantages of the constructs, including improved graft-to-bone integration, capabilities for sequential tensioning of the graft, and bone sparing effects, can be implemented.

scholarly journals Injury risk functions for the four primary knee ligaments

2021 ◽  
Author(s):  
Jiota Nusia ◽  
Jia Cheng Xu ◽  
Reimert Sjöblom ◽  
Johan Knälmann ◽  
Astrid Linder ◽  
...  
Keyword(s):  
Posterior Cruciate Ligament ◽  
Injury Risk ◽  
Failure Modes ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Knee Ligament ◽  
Knee Ligaments ◽  
Risk Functions

Aim: The purpose of this study was to develop Injury Risk Functions (IRFs) for the Anterior- and Posterior Cruciate Ligament (ACL and PCL, respectively) and the Medial- and Lateral Collateral Ligament (MCL and LCL, respectively) in the knee joint and address two injury mechanisms of the ligaments, mid-substance failure and ligament insertion detachment. Method: The IRFs were developed from Post-Mortem Human Subject (PMHS) tensile failure strains of Bone-Ligament-Bone (BLB) or dissected Ligament (LIG) preparations. To compensate for insufficient sample size of experimental datapoints, virtual failure strains were as well generated based on mean- and standard deviation from experiments that did not provide specimen-specific results. All virtual and specimen-specific values were then categorised into groups of static and dynamic rates and tested for the best fitting theoretical distribution to formulate the ligament IRF. Results: Nine IRFs were derived (3 for ACL, 2 for PCL, 1 for MCL and 3 for LCL). Conclusion: These IRFs are, to the best of the authors' knowledge, the first knee ligament injury predicting tool based on PMHS data. The IRFs of BLB address both failure modes of mid-ligament and attachment failure, while the IRFs of LIG address mid-ligament failures only. The proposed risk functions can be used to determine the effectiveness of injury prevention measures. Keywords: Injury risk functions, knee ligaments, anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament, lateral collateral ligament.

Knee Muscle and Ligament Forces During Drop Landing Exercise

2017 ◽  
Author(s):  
Dumitru I. Caruntu ◽  
Ricardo Moreno ◽  
Robert Freeman
Keyword(s):  
Inverse Dynamics ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Inequality Constraints ◽  
Standing Position ◽  
The Body ◽  
Muscle Forces ◽  
Collateral Ligament ◽  
Drop Landing ◽  
D Model

This work investigates the human leg muscle and ligaments forces during a drop-landing exercise. An inverse dynamics 2-D model of human leg is used on this ballistic task in order to predict these forces. The model consists of three bony structures, namely femur, tibia, and patella. The joints of the model are the knee joint and the hip joint. The ligamentous structure of the knee includes the two cruciate ligaments, Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL), and the two collateral ligaments, Lateral Collateral Ligament (LCL) and Medial Collateral Ligament (MCL). The system of muscles of the system includes muscle such as quadriceps, hamstrings, gastrocnemius are included in the model. Experimental data used show a maximum of 100 degrees of flexion angle and ground reaction forces up to 4 times the body weight. The inverse dynamics 2-D model consists of an objective function to minimize the muscle forces, and a set of constraints consisting of equality constraints which are the dynamics equations of the bony structures, and inequality constraints in which all muscle forces must be positive. All muscle forces show a pattern in which they reach large magnitudes at the beginning of landing, decreasing as the subject end the exercise with a standing position.

Biomechanical Properties of the Stifle Joint Lateral Collateral Ligament in Dogs

1992 ◽  
Vol 05 (04) ◽  
pp. 158-162 ◽  
Author(s):  
D. Blackketter ◽  
J Harari ◽  
J. Dupuis
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Biomechanical Properties ◽  
Fibular Head ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint

Bone/lateral collateral ligament/bone preparations were tested and structural mechanical properties compared to properties of cranial cruciate ligament in 15 dogs. The lateral collateral ligament has sufficient stiffness to provide stifle joint stability and strength to resist acute overload following fibular head transposition.

scholarly journals Functional Long-Term Outcome after Left- versus Right-Sided Intracerebral Hemorrhage

2017 ◽  
Vol 43 (3-4) ◽  
pp. 117-123 ◽  
Author(s):  
Vanessa D. Beuscher ◽  
Joji B. Kuramatsu ◽  
Stefan T. Gerner ◽  
Julia Köhn ◽  
Hannes Lücking ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Outcome Measures ◽  
A Priori ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Excellent Outcome ◽  
Confounding Variables ◽  
Baseline Characteristics

Background and Purpose: Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings. Methods: Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014. Data were retrieved from institutional databases. Outcome was assessed using the modified Rankin Scale (mRS) score. Outcome measures (long-term mortality and functional outcome at 12 months) were correlated with ICH location and hemisphere, and the imbalances of baseline characteristics were addressed by propensity score matching. Results: A total of 831 patients with supratentorial ICH (429 left and 402 right) were analyzed. Regarding clinical baseline characteristics in the unadjusted overall cohort, there were differences in disfavor of right-sided ICH (antiplatelets: 25.2% in left ICH vs. 34.3% in right ICH; p < 0.01; previous ischemic stroke: 14.7% in left ICH vs. 19.7% in right ICH; p = 0.057; and presence/extent of intraventricular hemorrhage: 45.0% in left ICH vs. 53.0% in right ICH; p = 0.021; Graeb-score: 0 [0-4] in left ICH vs. 1 [0-5] in right ICH; p = 0.017). While there were no differences in mortality and in the proportion of patients with favorable vs. unfavorable outcome (mRS 0-3: 142/375 [37.9%] in left ICH vs. 117/362 [32.3%] in right ICH; p = 0.115), patients with left-sided ICH showed excellent outcome more frequently (mRS 0-1: 64/375 [17.1%] in left ICH vs. 43/362 [11.9%] in right ICH; p = 0.046) in the unadjusted analysis. After adjusting for confounding variables, a well-balanced group of patients (n = 360/hemisphere) was compared showing no differences in long-term functional outcome (mRS 0-3: 36.4% in left ICH vs. 33.9% in right ICH; p = 0.51). Sub-analyses of patients with deep vs. lobar ICH revealed also no differences in outcome measures (mRS 0-3: 53/151 [35.1%] in left deep ICH vs. 53/165 [32.1%] in right deep ICH; p = 0.58). Conclusion: Previously described differences in clinical end points among patients with left- vs. right-hemispheric ICH may be driven by different baseline characteristics rather than by functional deficits emerging from different hemispheric functions affected. After statistical corrections for confounding variables, there was no impact of hemispheric location on functional outcome after ICH.

scholarly journals Imaging Findings of Knee Trauma on Magnetic Resonance Imaging

2022 ◽  
Vol 8 (1) ◽  
pp. 12-23
Author(s):  
Poonam Ohri ◽  
Shreeji Goya ◽  
Niveditha C ◽  
Manasi Kohli
Keyword(s):  
Anterior Cruciate Ligament ◽  
Imaging Modality ◽  
Cruciate Ligament ◽  
Age Groups ◽  
Lateral Collateral Ligament ◽  
Cost Effective ◽  
Collateral Ligament ◽  
Imaging Evaluation ◽  
Young Males ◽  
Anterior Cruciate

Background: Knee is one of the major joints involved in kinesis. With increasing involvement in sports related activities especially in young people, Trauma related knee pathologies have increased. An accurate diagnosis regarding the type and extent of injuries is essential for early operative as well as non-operative treatment. Methods:This prospective study included total of 82 cases. The patients were referred to the department of Radiodiagnosis from indoor and outdoor departments of Guru Nanak Dev Hospital, Amritsar with suspicion of internal derangement of the knee and with history of knee trauma.Results:The most common age group involved was young males between 15-34 years. In all age groups most of the patients were males. Most common ligament to be injured was Anterior Cruciate Ligament (ACL). Partial tears were more common than complete tears. Posterior Cruciate Ligament (PCL) tears were less common. Medial Collateral Ligament (MCL) tears outnumbered Lateral Collateral Ligament (LCL) tears and grade 2 tears were more common in both. Among the meniscal injuries Medial Meniscus (MM) tears were more common than LM and grade 3 signal was more common in both. Most of the patellar retinaculum injuries were associated with Anterior Cruciate Ligament ACL tears.Conclusions:Post-traumatic pre-arthroscopic MR imaging evaluation has proved to be cost-effective. MRI is an accurate imaging modality complementing the clinical evaluation and providing a global intra-articular and extra-articular assessment of the knee.

Radiological Identification of Injury to the Kaplan Fibers of the Iliotibial Band in Association With Anterior Cruciate Ligament Injury

2020 ◽  
Vol 48 (9) ◽  
pp. 2213-2220
Author(s):  
Lachlan M. Batty ◽  
Jerome Murgier ◽  
Julian A. Feller ◽  
Richard O’Sullivan ◽  
Kate E. Webster ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Lateral Collateral Ligament ◽  
Acl Injury ◽  
Iliotibial Band ◽  
Time Interval ◽  
Collateral Ligament ◽  
Tibial Bone ◽  
Mri Scans ◽  
Anterior Cruciate

Background: Recent biomechanical studies have demonstrated that the Kaplan fibers (KFs) of the iliotibial band play a role in the control of anterolateral rotation of the knee. However, controversy exists regarding whether the KFs are injured in conjunction with anterior cruciate ligament (ACL) injury. Purpose: To establish the prevalence of radiological injury to the KFs in the ACL-injured knee; to evaluate the effect of the time interval between injury and magnetic resonance imaging (MRI) on diagnosis of KF injury; and to assess for any association between KF injury and other qualitative radiological findings. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Preoperative MRI scans were reviewed for 161 patients with ACL injury. Specific diagnostic criteria were developed and applied to identify KF injury. Chi-square testing was performed to look for associations among KF injury, the time from injury to MRI, and associated radiological knee injuries. Results: Radiological evidence of KF injury was identified in 30 (18.6%) patients. The diagnosis of KF injury was higher in patients who had MRI scans performed within 90 days of injury as compared with ≥90 days after injury (23.7 vs 6.4%; P = .010). Patients with an MRI diagnosis of KF injury had significantly higher rates of lateral meniscal injury (40% vs 18%; P = .007), posteromedial tibial bone marrow edema (73% vs 44%; P = .003), and injury to the lateral collateral ligament (13% vs 3%; P = .019) or medial collateral ligament (23% vs 8%; P = .019). Conclusion: The prevalence of injury to the KF in patients with ACL injury as diagnosed by MRI was relatively low (18.6% of patients). However, the time interval from injury to MRI was relevant to diagnosis, with significantly higher rates of injury identification in patients with early (within 90 days) versus delayed (≥90 days) MRI. KF injury was associated with higher rates of injury to the lateral meniscal and collateral ligaments, as well as posteromedial tibial bone bruising.

Sign in / Sign up

Export Citation Format

Share Document