Abnormal Rotational Knee Motion during Running after Anterior Cruciate Ligament Reconstruction

Tashman, Scott; Collon, David; Anderson, Kyle; Kolowich, Patricia A.; Anderst, William

doi:10.1177/0363546503261709

Cited by 656 publications

(611 citation statements)

References 41 publications

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“…Furthermore, studies have suggested that the ability of current reconstruction techniques to prevent degenerative changes compared with nonoperative treatment is limited [11,[13][14][15]36]. Although many mechanisms likely contribute to this degeneration (for example, traumatic injury to other soft tissues at the time of ACL rupture), numerous authors suggest the inability of the reconstruction to restore normal joint kinematics is an important factor [17,34,39,50,53,54].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

139

143

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Grafts placed too anteriorly on the femur are reportedly a common cause of failure in anterior cruciate ligament reconstruction. Some studies suggest more anatomic femoral tunnel placement improves kinematics. The ability of the transtibial technique and a tibial tunnel-independent technique (placed transfemorally outside-in) to place the guide pin near the center of the femoral attachment of the anterior cruciate ligament was compared in 12 cadavers. After arthroscopic placement of the guide pins, the femur was dissected and the three-dimensional geometry of the femur, anterior cruciate ligament footprint, and positions of each guide pin were measured. The transtibial guide-pin placement was 7.9 ± 2.2 mm from the center of the footprint (near its anterior border), whereas the independent technique positioned the guide pin 1.9 ± 1.0 mm from the center. The center of the footprint was within 2 mm of an anteroposterior line through the most posterior border of the femoral cartilage in the notch and a proximodistal line through the proximal margin of the cartilage at the capsular reflection. More accurate placement of the femoral tunnel might reduce the incidence of graft failure and might reduce long-term degeneration observed after reconstruction although both would require clinical confirmation.

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Section: Introductionmentioning

confidence: 99%

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Kaseta

DeFrate

Charnock

et al. 2008

Clinical Orthopaedics &Amp; Related Research

139

143

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show abstract

“…Compared to skin mounted markers, our system does not suffer from relative movements between the skin and the bone, and is thus suitable for accurate joint kinematics studies [6,7,8]. Our method proved to be stable without relying on implanted markers or joint implants, that will return more accurate results at the price of high invasiveness [5,9,11].…”

Section: Discussionmentioning

confidence: 99%

“…Our method proved to be stable without relying on implanted markers or joint implants, that will return more accurate results at the price of high invasiveness [5,9,11] We thank the reviewer for the comment and for the suggestion. In our paper, we must differentiate between two types of landmarks: the first type are 3D landmarks on the shapes as are usually called in literature [18,19].…”

Section: Powered By Editorial Manager® and Produxion Manager® From Armentioning

confidence: 98%

“…The second method is based on tantalum markers implanted in the bone; even if this method is much more precise than the previous one, it is not commonly used in clinics due to the high invasiveness of the intervention [9,5,10]. In [11], the authors used mono and biplane fluoroscopic images to accurately reconstruct the pose of the patella, implanting markers in cadaver specimens and artificially flexing the knee joint.…”

Section: Fig8 : "Exted" -> "Extend"mentioning

confidence: 99%

“…The ionizing radiation given to the patient in our procedure is just a few hundredths of a mSv (considering a total of 22 images and an average dose of 0.001mSv for each image, we have a total dose of 0.02mSv, much lower than a 2.2mSv average dose absorbed with a CT) [29, 30]. Compared to skin mounted markers, our system does not suffer from relative movements between the skin and the bone, and is thus suitable for accurate joint kinematics studies [6,7,8].Our method proved to be stable without relying on implanted markers or joint implants, that will return more accurate results at the price of high invasiveness [5,9,11] We thank the reviewer for the comment and for the suggestion. In our paper, we must differentiate between two types of landmarks: the first type are 3D landmarks on the shapes as are usually called in literature [18,19].…”

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confidence: 95%

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Fluoroscopy-based tracking of femoral kinematics with statistical shape models

Valenti

Momi

et al. 2015

Int J CARS

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Abstract:Purpose Precise knee kinematics assessment helps to diagnose knee pathologies and to improve the design of customized prosthetic components. The first step in identifying knee kinematics is to assess the femoral motion in the anatomical frame. However, no work has been done on pathological femurs, whose shape can be highly different from healthy ones. Method We propose a new femoral tracking technique based on Statistical Shape Models (SSMs) and two calibrated fluoroscopic images, taken at different flexion-extension angles. The cost function optimization is based on genetic algorithms, to avoid local minima. The proposed approach was evaluated on 3 sets of digitally reconstructed radiographic images of osteoarthritic patients. Results It is found that using the estimated shape, rather than that calculated from CT, significantly reduces the pose accuracy, but still has reasonably good results (angle errors around 2 degrees, translation around 1.5mm). Cover Letter. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationThe authors thank the reviewers and the editor for their interest in this topic and for giving them the possibility to improve the paper with their comments. Hereunder we answer the questions arisen, with indications on the changes made to the manuscript According to the reviewer comment, we modified the text in the "State of the Art" section as follows:"Knee kinematics assessment has great importance both to understand the problems associated with a large number of knee pathologies and to improve the design of prosthetic components. In case of severe osteoarthritis, that are eligible for joint implant surgery, in vivo pre-operatory knee kinematics is fundamental to understand the relative motion between the three joint bones. The relative movement can give an insight of how the ligaments are stretched and their stability, and how could be the feeling for the patient. In this way, pre operatory knee kinematics could help the surgeon to decide which prosthesis should be used and how to correct the misalignment of the bones [3]. Currently, the reconstruction of the pose of the knee can be done using 3D scans such as real-time Magnetic Resonance Imaging (MRI) or through a 2D/3D registration method that superimposes the shape extracted from MRI or Computed Tomography (CT) onto an image, usually X-ray or fluoroscopy. Real-time MRI is suitable to study joint kinematics, as it evidences the muscle structure during movements. However, it can only be used with relatively slow movements, and the accuracy obtained increases from 1mm to more than 3mm depending on the velocity of the movement. In addition, MRI scans are highly expensive [4]. Traditional CT and MRI provide an accurate evaluation of the morphology of the knee, but are limited to static positioning of the patient.[…]The use of dynamic fluoroscopy to detect knee kinematics is described in [12]. The authors use a fluoroscopic system flashing at 30Hz, obtaining continuous images of the knee flexion from 0° to 120°...

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Side Variations of Anterior Cruciate Ligament Coronal Angles: Implications for ACL Reconstruction

et al. 2019

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Current literature has shown a biomechanical advantage of recreating the native coronal obliquity of the anterior cruciate ligament (ACL) during grating procedures; however, the majority of studies on ACL morphological variation have been performed unilaterally. This cadaveric study aimed to evaluate sided ACL coronal angle of inclination variation including trend analysis with sex, age, height, and femoral condyle width. The ACLs of 57 embalmed cadaveric specimens were evaluated bilaterally for a total of 114 ACLs. The knees were flexed to 110 . A 0.70-mm wire measured coronal angulation through the lateral tibial plateau and the medial ACL border. An image taken of the wire allowed digital measurement with the ImageJ software. IBM SPSS was utilized for statistical analysis. Bilateral measurements demonstrated a difference in an individual's sided ACL angulation (P < 0.001). Right-sided angulation was greater in 61.4% (35/57). In cadavers with greater right-side angulation, right ACLs averaged 66.2 versus left ACLs averaged 60.9 (P < 0.001). Cadavers with greater leftsided ACL angles demonstrated average left ACLs measuring 65.5 versus right ACLs measuring 60.6 (P < 0.001). Right-sided angles were greater in 69.7% of females. Understanding the anatomy of the ACL's native coronal angle and variations between a patient's knees is imperative during reconstruction surgery to aid in anatomic tunnel placement for improved knee motion and rotational knee kinematics following surgery. A statistically significant difference exists between an individual's right and left ACL coronal angles of inclination.

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Abnormal Rotational Knee Motion during Running after Anterior Cruciate Ligament Reconstruction

Abstract: Although further study is required, these abnormal motions may contribute to long-term joint degeneration associated with anterior cruciate ligament injury/reconstruction.

Cited by 656 publications

References 41 publications

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Reconstruction Technique Affects Femoral Tunnel Placement in ACL Reconstruction

Fluoroscopy-based tracking of femoral kinematics with statistical shape models

Side Variations of Anterior Cruciate Ligament Coronal Angles: Implications for ACL Reconstruction

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