scholarly journals The influence of ruptured anterior cruciate ligament on the biomechanical weakening of knee joint and posterior cruciate ligament

2016 ◽  
Vol 10 (2) ◽  
pp. 1-8 ◽  
Author(s):  
A. Vulovic ◽  
A. Vukicevic ◽  
G. Jovicic ◽  
B. Ristic ◽  
N. Filipovic
2016 ◽  
Vol 2 (2) ◽  
pp. 175-179
Author(s):  
Atina Izzah Kusumaningrum ◽  
Lidya Purna WS Kuntjoro ◽  
Gatot Murti Wibowo

Background: There are clinical situations that radiology physicians need to assess Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) clearly with the two typical sequences (T2WI FSE sequence and Proton Density Fat Saturation). However, a slight difference in using the applied sequences will result different levels of image quality information. The aim of this study is to compare clinical  manifest in anatomical information on the resulted images between  T2WI FSE sequence and Proton Density Fat Saturation and to define the best sequence that fit to reveal ACL and PCL of the knee joint..Methods: The research was an experimental quasy. 20 sagital slices of  the knee jointMRI were acquired from 10 volunteers who underwent MRI examinations with the two methods (T2WI FSE and Proton Density Fat Saturation). 3 experienced radiology physicians blended in the image scoring when review ACL and PCL appearances on knee MRI images. Inter-observer suitability was checked with Kappa test. A non-parametric Wilcoxon analyses was the statistical tool to test the null hypothesis.Results: The result showed a significant difference in anatomical information of ACL and PCL when T2WI FSE and Proton Density Fat Saturation sequences applied on the MRI of the knee jointsagital slices (p-value 0,05). The mean rank of T2WI FSE was better than Proton Density Fat Saturation  which contributed to the value at 4,50. There was an increase in signals that lead to ACL and PCL appear to be more hyper-intens compared to sorrounding organs in general, except the border line  of PCL.  By this means, it was useful for evaluating the patient whose particularly with ACL post-grafting.Conclusion: There was the difference in anatomical information between T2WI FSE sequence and Proton Density Fat Saturation on MRI knee jointwith sagital slices for ACL and PCL studies.  T2WI FSE sequence was the best method for showing anatomical information of ACL and PCL, although a relative low signal still occured from border line  of PCL.


2018 ◽  
Vol 1 (84) ◽  
Author(s):  
Vilma Jurevičienė ◽  
Albertas Skurvydas ◽  
Juozas Belickas ◽  
Giedra Bušmanienė ◽  
Dovilė Kielė ◽  
...  

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.


2017 ◽  
Vol 31 (08) ◽  
pp. 736-746 ◽  
Author(s):  
Jonathan Kosy ◽  
Vipul Mandalia

AbstractMechanoreceptors, within the anterior cruciate ligament (ACL), are believed to have importance in proprioception, contributing to dynamic knee stability. The potential for reinnervation of the ACL graft is one of the proposed advantages of remnant-preserving reconstruction. The aim of this review is to summarize advances in the basic science underpinning this function, alongside recent clinical studies, to define the current role for remnant-preservation.A comprehensive systematic review was performed using PubMed and Medline searches. Studies were analyzed with particular focus placed on the methodology used to either identify mechanoreceptors or test proprioception.Contemporary work, using immunohistological staining, has shown mechanoreceptors primarily within proximity to the bony attachments of the ACL (peripherally in the subsynovial layer). The number of these receptors has been shown to decrease rapidly, following rupture, with adhesion to the posterior cruciate ligament slowing this decline. Recent studies have shown proprioceptive deficits, in both the injured and contralateral knees, with the clinical relevance of findings limited by testing methodology and the small differences found. The advantages of remnant-preservation, seen primarily in animal studies, have not been shown in systematic reviews or meta-analysis of clinical studies.The potential for reinnervation of the graft is likely time-dependent and reliant on continued loading of the remnant. Therefore, current clinical use and future research should focus on preserving remnants within 6 months of injury that remain loaded by adherence to the posterior cruciate ligament. Subsequent testing should account for central neurological changes and focus on clinically relevant outcomes.


2013 ◽  
Vol 29 (12) ◽  
pp. 1963-1973 ◽  
Author(s):  
Eleni Triantafyllidi ◽  
Nikolaos K. Paschos ◽  
Anna Goussia ◽  
Nektaria-Marianthi Barkoula ◽  
Dimitrios A. Exarchos ◽  
...  

Author(s):  
Julio Cesar Gali ◽  
Tyago Araujo Almeida ◽  
Daniela Cristina de Moraes Miguel ◽  
Samir Alexandre Nassar ◽  
Julio Cesar Gali Filho ◽  
...  

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.


2018 ◽  
Vol 32 (11) ◽  
pp. 1111-1120
Author(s):  
Robin Otchwemah ◽  
Jan-Hendrik Naendrup ◽  
Frauke Mattner ◽  
Thorsten Tjardes ◽  
Holger Bäthis ◽  
...  

AbstractKnee joint infections constitute a rare but devastating complication after anterior cruciate ligament (ACL) reconstruction. We hypothesized that effective infection therapy and graft preservation is possible following a standard treatment protocol. We retrospectively analyzed all patients admitted to our center with suspected infection of the knee after ACL reconstruction between 2010 and 2012. Following a standardized protocol, blood samples were drawn and synovial fluid was analyzed. Furthermore, the protocol consisted of arthroscopic lavages and debridements of the anterior and posterior joint compartments over three incisions, and targeted antibiotic therapy over a period of 6 weeks. Surgeries were repeated every 2 days until clinical signs of infections resolved, but at least two times. Mean observation period was 10 months. Forty-one patients aged 31 ( ±  9.9) years and admitted 14 ( ±  7.5) days after ACL reconstruction were included. Pathogens were found in 34 patients and coagulase-negative staphylococci were isolated most commonly (31 isolates in 28 patients). Quinolones were the most commonly used antibiotic agents. Mean number of operations was 3.8 ( ± 1.4). Following the standard protocol, primary successful infection treatment with graft preservation was possible in 37 of the included 41 patients. Graft preservation was achieved in 100% of the included patients with Gaechter stage 1 and 2 infections. Knee joint infection after ACL reconstruction was successfully treated following a standardized protocol, and graft preservation was reliably achieved especially in cases with infections at an early stage.


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