A noninvasive MRI based approach to estimate the mechanical properties of human knee ligaments

Beidokhti, Hamid Naghibi; Mazzoli, Valentina; Gijsbertse, Kaj; Hannink, Gerjon; Sprengers, André; Janssen, Dennis; Boogaard, A.H. van den

doi:10.1016/j.jmbbm.2019.01.022

Cited by 11 publications

(4 citation statements)

References 36 publications

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“…3 Chu and Williams 6 found that the mean ACL graft T2* increased 25% to 30% during the first 6 months ( P < .013) and decreased 19% between 1 and 2 years after ACL reconstruction. Naghibi et al 23 found a correlation between T2* and mechanical properties (stiffness and rupture force) of human knee ligaments. In this study, we found that the T2* value of the NRTS group was significantly larger than that of the RTS group (17.69 ± 2.48 vs 14.92 ± 2.28; P < .001) and a moderate correlation ( r = −0.41; P = .02) was found between T2* and RTS.…”

Section: Discussionmentioning

confidence: 99%

Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft

Zhou,

Xu,

Zhang

et al. 2024

Orthopaedic Journal of Sports Medicine

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Background: The relationship between graft maturity on magnetic resonance imaging (MRI) and return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction is unclear. Purpose: To compare signal-to-noise quotient (SNQ) values and ACL graft T2* (gradient echo) values between patients who did RTS and those who did not RTS (NRTS) after ACL reconstruction and to evaluate the predictive value of T2* mapping for RTS after ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: At a minimum of 9 months after arthroscopic single-bundle ACL reconstruction with autologous hamstring tendon graft, 82 patients underwent RTS assessment as well as MRI evaluation. The patients were classified into RTS (n = 53) and NRTS (n = 29) groups based on the results of the assessment. The SNQ values in the proximal, middle, and distal regions of the graft and the T2* values of the graft were measured on MRI. The correlation between T2* values and RTS was assessed using Spearman correlation analysis. Receiver operating characteristic curves were constructed to compare the diagnostic performance, and the optimal T2* cutoff value for detecting RTS was determined based on the maximum Youden index. Results: At 9 months after ACL reconstruction, the proximal, middle, and mean SNQ values in the RTS group were significantly lower than those in the NRTS group (proximal: 17.15 ± 4.85 vs 19.55 ± 5.05, P = .038; middle: 13.45 ± 5.15 vs. 17.75 ± 5.75, P = .001; mean: 12.37 ± 2.74 vs 15.07 ± 3.32, P < .001). The T2* values were lower in the RTS group (14.92 ± 2.28 vs 17.69 ± 2.48; P < .001) and were correlated with RTS ( r = −0.41; P = .02). The area under the curve of T2* was 0.79 (95% CI, 0.75-0.83), and the optimal cutoff value for T2* was 16.65, with a sensitivity and specificity for predicting failure to RTS of 67.9% and 88.2%, respectively. Conclusion: Study findings indicated that the SNQs (mean, proximal, and middle) and the T2* values of the graft in the RTS group were significantly lower than those in NRTS group. A T2* value of 16.65 was calculated to predict patients who failed RTS tests with a sensitivity of 67.9% and specificity of 88.2%.

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Section: Discussionmentioning

confidence: 99%

Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft

Zhou,

Xu,

Zhang

et al. 2024

Orthopaedic Journal of Sports Medicine

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“…However, in vivo patient-specific models with validated ligament properties have not yet been reported in the literature. Promising work has been done to correlate magnetic resonance images with in vivo ligamentous material properties 38 and may assist in the development of these patient-specific models in future studies. In addition, the validation step of the FE model was performed relative to a knee flexion angle of 25°.…”

Section: Methodsmentioning

confidence: 99%

Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes

Ueno

Navacchia

Schilaty

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Frontal plane trunk lean with a side-to-side difference in lower extremity kinematics during landing increases unilateral knee abduction moment and consequently anterior cruciate ligament (ACL) injury risk. However, the biomechanical features of landing with higher ACL loading are still unknown. Validated musculoskeletal modeling offers the potential to quantify ACL strain and force during a landing task. Purpose: To investigate ACL loading during a landing and assess the association between ACL loading and biomechanical factors of individual landing strategies. Study Design: Descriptive laboratory study. Methods: Thirteen young female athletes performed drop vertical jump trials, and their movements were recorded with 3-dimensional motion capture. Electromyography-informed optimization was performed to estimate lower limb muscle forces with an OpenSim musculoskeletal model. A whole-body musculoskeletal finite element model was developed. The joint motion and muscle forces obtained from the OpenSim simulations were applied to the musculoskeletal finite element model to estimate ACL loading during participants’ simulated landings with physiologic knee mechanics. Kinematic, muscle force, and ground-reaction force waveforms associated with high ACL strain trials were reconstructed via principal component analysis and logistic regression analysis, which were used to predict trials with high ACL strain. Results: The median (interquartile range) values of peak ACL strain and force during the drop vertical jump were 3.3% (–1.9% to 5.1%) and 195.1 N (53.9 to 336.9 N), respectively. Four principal components significantly predicted high ACL strain trials, with 100% sensitivity, 78% specificity, and an area of 0.91 under the receiver operating characteristic curve ( P < .001). High ACL strain trials were associated with (1) knee motions that included larger knee abduction, internal tibial rotation, and anterior tibial translation and (2) motion that included greater vertical and lateral ground-reaction forces, lower gluteus medius force, larger lateral pelvic tilt, and increased hip adduction. Conclusion: ACL loads were higher with a pivot-shift mechanism during a simulated landing with asymmetry in the frontal plane. Specifically, knee abduction can create compression on the posterior slope of the lateral tibial plateau, which induces anterior tibial translation and internal tibial rotation. Clinical Relevance: Athletes are encouraged to perform interventional and preventive training to improve symmetry during landing.

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“…Using digital image correlation (DIC), live strain mapping during tensile testing was conducted. The native MCL/Scaffold/Repair site was prepared following similar techniques previously published in the literature 9,10 . We followed the recommendations of the International Digital Image Correlation Society as closely as possible, having a speckle pattern on the site's medial surface with each speckle being 3 to 5 pixels in diameter, as close to 50/50 distribution of black and white on the specimen as feasible, and creating facets with 3‐5 speckles per facet.…”

Section: Methodsmentioning

confidence: 99%

Multiphasic scaffold for scapholunate interosseous ligament reconstruction: A study in the rabbit knee

Vaquette

Denbeigh

et al. 2020

Journal Orthopaedic Research

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Scapholunate interosseous ligament tears are a common wrist injury in young and active patients that can lead to suboptimal outcomes after repair. This research aims to assess a multiphasic scaffold using 3D‐printing for reconstruction of the dorsal scapholunate interosseous ligament. The scaffold was surgically implanted in vivo in the position of the native rabbit medial collateral ligament. Two branches of treatment were implemented in the study. In the first group, the rabbits (n = 8) had the knee joint fixed in flexion for 4 weeks using 1.4 mm K‐wires prior to sample harvesting. The second group (n = 8) had the rabbit knee joint immobilized for 4 weeks prior to K‐wire removal and mobilization for an additional 4 weeks prior to sample harvesting. Overall, samples were harvested at 4 weeks post‐surgery (immobilized group) and eight weeks post‐surgery (mobilized group). Mechanical tensile testing (n = 5/group) and histology (n = 3/group) of the constructs were conducted. Tissue integration and maturation were observed resulting in increased mechanical strength of the operated joint at 8 weeks (P < .05). Bone and ligament tissues were regenerated in their respective compartments with structural and mechanical properties approaching those reported for the human dorsal SLIL ligament. Clinical Significance: This proof of concept study has demonstrated that the synthetic multiphasic scaffold was capable of regenerating both bone and ligament while also withstanding the physiological load once implanted in the rabbit knee. The artificial scaffold may provide an alternative to current techniques for reconstruction of scapholunate instability or other ligament injuries in the hand and wrist.

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A noninvasive MRI based approach to estimate the mechanical properties of human knee ligaments

Cited by 11 publications

References 36 publications

Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft

Association of Graft Maturity on MRI With Return to Sports at 9 Months After Primary Single-Bundle ACL Reconstruction With Autologous Hamstring Graft

Anterior Cruciate Ligament Loading Increases With Pivot-Shift Mechanism During Asymmetrical Drop Vertical Jump in Female Athletes

Multiphasic scaffold for scapholunate interosseous ligament reconstruction: A study in the rabbit knee

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