Partial Anterior Cruciate Ligament Ruptures: Knee Laxity Measurements and Pivot Shift

Ohashi, Bruno; Ward, James; Araújo, Paulo; Kfuri, Maurício; Pereira, Hélder; Espregueira-Mendes, João; Musahl, Volker

doi:10.1007/978-3-642-36569-0_85

Cited by 3 publications

(3 citation statements)

References 67 publications

(49 reference statements)

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“…Because morphologic MRI fails in differentiating partial from complete ACL injuries [8,12,13] and stress radiography lacks precision and standardisation [19][20][21]27], consensus is growing that joint stability must be assessed more precisely, reliably, and objectively [10,13,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…While complete ACL tears are identified with excellent sensitivity and specificity [4], partial ACL tears are diagnosed with considerably poorer sensitivity and specificity [5,6], even if standard clinical MRI protocols are supplemented by oblique or 3D volume sequences [7,8]. With an estimated prevalence of 20-47% of all ACL injuries [9], partial ACL tears involve the anteromedial or posterolateral bundle [10] or up to 75% of the ligament's diameter [11]. Due to their various injury patterns and imaging features, partial ACL tears are oftentimes indistinguishable from complete injuries, mucoid degeneration or even the normal ACL [12].…”

Section: Introductionmentioning

confidence: 99%

“…However, there is an important clinical need for an accurate distinction of partial from complete ACL injuries as it impacts the type of treatment, i.e., conservative versus surgical, and the exact operative technique and workflow for ACL reconstruction [9,[13][14][15]. Consequently, patients with suspected ACL injury may undergo arthroscopy [9] that they could be spared if preoperative diagnostics were improved [10,13,[16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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Seeing Beyond Morphology-Standardized Stress MRI to Assess Human Knee Joint Instability

et al. 2021

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While providing the reference imaging modality for joint pathologies, MRI is focused on morphology and static configurations, thereby not fully exploiting the modality’s diagnostic capabilities. This study aimed to assess the diagnostic value of stress MRI combining imaging and loading in differentiating partial versus complete anterior cruciate ligament (ACL)-injury. Ten human cadaveric knee joint specimens were subjected to serial imaging using a 3.0T MRI scanner and a custom-made pressure-controlled loading device. Emulating the anterior-drawer test, joints were imaged before and after arthroscopic partial and complete ACL transection in the unloaded and loaded configurations using morphologic sequences. Following manual segmentations and registration of anatomic landmarks, two 3D vectors were computed between anatomic landmarks and registered coordinates. Loading-induced changes were quantified as vector lengths, angles, and projections on the x-, y-, and z-axis, related to the intact unloaded configuration, and referenced to manual measurements. Vector lengths and projections significantly increased with loading and increasing ACL injury and indicated multidimensional changes. Manual measurements confirmed gradually increasing anterior tibial translation. Beyond imaging of ligament structure and functionality, stress MRI techniques can quantify joint stability to differentiate partial and complete ACL injury and, possibly, compare surgical procedures and monitor treatment outcomes.

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