Document Detail


Evaluating rotational kinematics of the knee in ACL reconstructed patients using 3.0Tesla magnetic resonance imaging.
MedLine Citation:
PMID:  22264714     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Injury to the anterior cruciate ligament (ACL) is common. While prior studies have shown that surgical reconstruction of the ACL can restore anterior-posterior kinematics, ACL-injured and reconstructed knees have been shown to have significant differences in tibial rotation when compared to uninjured knees. Our laboratory has developed an MR compatible rotational loading device to objectively quantify rotational stability of the knee following ACL injuries and reconstructions. Previous work from our group demonstrated a significant increase in total tibial rotation following ACL injuries. The current study is a prospective study on the same cohort of patients who have now undergone ACL reconstruction. We hypothesize that ACL reconstructed knees will have less tibial rotation relative to the pre-operative ACL deficient condition. We also hypothesize that ACL reconstructed knees will have greater rotational laxity when compared to healthy contralateral knees. METHODS: Patients. Six of the ACL injured patients from our initial study who had subsequently undergone ACL reconstruction were evaluated 8.1±2.9 months after surgery. All patients underwent single-bundle ACL reconstruction using anteromedial portal drilling of the femoral tunnel with identical post-operative regimens. Magnetic Resonance (MR) Imaging. Patients were placed in a supine position in the MR scanner on a custom-built loading device. Once secured in the scanner bore, an internal/external torque was applied to the foot. The tibiae were semi-automatically segmented with in-house software. Tibial rotation comparisons were made within subjects (i.e. side-to-side comparison between reconstructed and contralateral knees) and differences were explored using paired sample t-tests with significance set at p=0.05. RESULTS: Regarding tibial rotation, in the ACL deficient state, these patients experienced an average of 5.9±4.1° difference in tibial rotation between their ACL deficient and contralateral knees. However, there was a -0.2±6.1° difference in tibial rotation of the ACL reconstructed knee when compared to the contralateral uninjured knee. Regarding tibial translation, ACL deficient patients showed a difference of 0.75±1.4mm of anterior tibial translation between injured and healthy knees. After ACL reconstruction, there was a 0.2±1.1mm difference in coupled anterior tibial translation of the ACL reconstructed knee compared to the contralateral knee. No significant differences in contact area between the two time points could be discerned. DISCUSSION: The objective of our study was to assess the rotational laxity present in ACL reconstructed knees using a previously validated MRI-compatible rotational loading device. Our study demonstrated that ACL reconstruction can restore rotational laxity under load. This may speak to the benefit of an anteromedial drilling technique, which allows for a more horizontal and anatomically appropriate graft position.
Authors:
Abbas Kothari; Bryan Haughom; Brian Feeley; Xiaojuan Li; C Benjamin Ma
Related Documents :
8747354 - Fixation of slipped capital femoral epiphyses with unthreaded 2-mm wires.
4093224 - Factors influencing the incidence of reoperation after femoral neck fractures.
21661674 - Double-bundle and double-tunnel acl reconstruction with looped proximal tibial fixation.
18438884 - Biomaterial-loaded allograft threaded cage for the treatment of femoral head osteonecro...
7127964 - Analysis of revision surgery of resurfacing hip arthroplasty.
21173624 - Hooks and wires--tried and true plus how to: posna1-daycourse, april 29, 2009.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-19
Journal Detail:
Title:  The Knee     Volume:  -     ISSN:  1873-5800     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9430798     Medline TA:  Knee     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier B.V. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Clinical results of open synovectomy for treatment of diffuse pigmented villonodular synovitis of th...
Next Document:  Robotic-assisted unicompartmental knee arthroplasty in a patient with combined medial compartment ar...