Skip to main content
Erschienen in: Current Reviews in Musculoskeletal Medicine 2/2016

06.04.2016 | ACL Update: Objective Measures on Knee Instability (V Musahl, Section Editor)

Functional knee assessment with advanced imaging

verfasst von: Keiko Amano, Qi Li, C. Benjamin Ma

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 2/2016

Einloggen, um Zugang zu erhalten

Abstract

The purpose of anterior cruciate ligament (ACL) reconstruction is to restore the native stability of the knee joint and to prevent further injury to meniscus and cartilage, yet studies have suggested that joint laxity remains prevalent in varying degrees after ACL reconstruction. Imaging can provide measurements of translational and rotational motions of the tibiofemoral joint that may be too small to detect in routine physical examinations. Various imaging modalities, including fluoroscopy, computed tomography (CT), and magnetic resonance imaging (MRI), have emerged as powerful methods in measuring the minute details involved in joint biomechanics. While each technique has its own strengths and limitations, they have all enhanced our understanding of the knee joint under various stresses and movements. Acquiring the knowledge of the complex and dynamic motions of the knee after surgery would help lead to improved surgical techniques and better patient outcomes.
Literatur
1.
Zurück zum Zitat Musahl V, Kopf S, Rabuck S, et al. Rotatory knee laxity tests and the pivot shift as tools for ACL treatment algorithm. Knee Surg Sport Traumatol Arthrosc. 2012;20(4):793–800. doi:10.1007/s00167-011-1857-6.CrossRef Musahl V, Kopf S, Rabuck S, et al. Rotatory knee laxity tests and the pivot shift as tools for ACL treatment algorithm. Knee Surg Sport Traumatol Arthrosc. 2012;20(4):793–800. doi:10.​1007/​s00167-011-1857-6.CrossRef
2.
Zurück zum Zitat Tsoukas D, Fotopoulos V, Basdekis G, Makridis KG. No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years. Knee Surg Sport Traumatol Arthrosc. 2015;(3). doi:10.1007/s00167-015-3593-9. Tsoukas D, Fotopoulos V, Basdekis G, Makridis KG. No difference in osteoarthritis after surgical and non-surgical treatment of ACL-injured knees after 10 years. Knee Surg Sport Traumatol Arthrosc. 2015;(3). doi:10.​1007/​s00167-015-3593-9.
3.
Zurück zum Zitat Ramski DE, Kanj WW, Franklin CC, Baldwin KD, Ganley TJ. Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med. 2013:1–8. doi:10.1177/0363546513510889. Ramski DE, Kanj WW, Franklin CC, Baldwin KD, Ganley TJ. Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med. 2013:1–8. doi:10.​1177/​0363546513510889​.
4.
Zurück zum Zitat Chalmers PN, Mall NA, Moric M. Does ACL reconstruction alter natural history? a systematic literature review of long-term outcomes. J Bone Jt Surg. 2014;96(4):292–300. doi:10.2106/JBJS.L.01713.CrossRef Chalmers PN, Mall NA, Moric M. Does ACL reconstruction alter natural history? a systematic literature review of long-term outcomes. J Bone Jt Surg. 2014;96(4):292–300. doi:10.​2106/​JBJS.​L.​01713.CrossRef
6.
Zurück zum Zitat Smith TO, Postle K, Penny F, McNamara I, Mann CJV. Is reconstruction the best management strategy for anterior cruciate ligament rupture? a systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus non-operative treatment. Knee. 2014;21(2):462–70. doi:10.1016/j.knee.2013.10.009.CrossRefPubMed Smith TO, Postle K, Penny F, McNamara I, Mann CJV. Is reconstruction the best management strategy for anterior cruciate ligament rupture? a systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus non-operative treatment. Knee. 2014;21(2):462–70. doi:10.​1016/​j.​knee.​2013.​10.​009.CrossRefPubMed
7.
Zurück zum Zitat Musahl V, Seil R, Zaffagnini S, Tashman S, Karlsson J. The role of static and dynamic rotatory laxity testing in evaluating ACL injury. Knee Surg Sport Traumatol Arthrosc. 2012;20(4):603–12. doi:10.1007/s00167-011-1830-4.CrossRef Musahl V, Seil R, Zaffagnini S, Tashman S, Karlsson J. The role of static and dynamic rotatory laxity testing in evaluating ACL injury. Knee Surg Sport Traumatol Arthrosc. 2012;20(4):603–12. doi:10.​1007/​s00167-011-1830-4.CrossRef
8.
Zurück zum Zitat Kocher MS. Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32(3):629–34. doi:10.1177/0363546503261722.CrossRefPubMed Kocher MS. Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32(3):629–34. doi:10.​1177/​0363546503261722​.CrossRefPubMed
14.
Zurück zum Zitat Brandsson S, Karlsson J, Swärd L, Kartus J, Eriksson BI, Kärrholm J. Kinematics and laxity of the knee joint after anterior cruciate ligament reconstruction: pre- and postoperative radiostereometric studies. Am J Sports Med. 2016;30(3):361–7. http://www.ncbi.nlm.nih.gov/pubmed/12016076 Accessed February 21, 2016. Brandsson S, Karlsson J, Swärd L, Kartus J, Eriksson BI, Kärrholm J. Kinematics and laxity of the knee joint after anterior cruciate ligament reconstruction: pre- and postoperative radiostereometric studies. Am J Sports Med. 2016;30(3):361–7. http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​12016076 Accessed February 21, 2016.
15.
Zurück zum Zitat Hofbauer M, Thorhauer ED, Abebe E, Bey M, Tashman S. Altered tibiofemoral kinematics in the affected knee and compensatory changes in the contralateral knee after anterior cruciate ligament reconstruction. Am J Sports Med. 2014. doi:10.1177/0363546514549444.PubMed Hofbauer M, Thorhauer ED, Abebe E, Bey M, Tashman S. Altered tibiofemoral kinematics in the affected knee and compensatory changes in the contralateral knee after anterior cruciate ligament reconstruction. Am J Sports Med. 2014. doi:10.​1177/​0363546514549444​.PubMed
17.
19.
20.•
Zurück zum Zitat Hosseini A, Li J-S, Gill TJ, Li G. Meniscus injuries alter the kinematics of knees with anterior cruciate ligament deficiency. Orthop J Sport Med. 2014;2(8):2325967114547346. doi:10.1177/2325967114547346. Using dual flouroscopic imaging techniques combined with 3D-MRI for bone model reconstruction, this study observed the kinematic behavior of ACL-deficient knees with meniscus tears during stair ascending activities. This is a typical 2D–3D image matching method, and the study demonstrated that combined ACL/meniscus injury could alter the kinematics of ACL-injured knees in a different way compared with knees with isolated ACL tears. This can lead to future studies to specificify treatments for patients with combined ACL/meniscus injuries. CrossRef Hosseini A, Li J-S, Gill TJ, Li G. Meniscus injuries alter the kinematics of knees with anterior cruciate ligament deficiency. Orthop J Sport Med. 2014;2(8):2325967114547346. doi:10.​1177/​2325967114547346​. Using dual flouroscopic imaging techniques combined with 3D-MRI for bone model reconstruction, this study observed the kinematic behavior of ACL-deficient knees with meniscus tears during stair ascending activities. This is a typical 2D–3D image matching method, and the study demonstrated that combined ACL/meniscus injury could alter the kinematics of ACL-injured knees in a different way compared with knees with isolated ACL tears. This can lead to future studies to specificify treatments for patients with combined ACL/meniscus injuries. CrossRef
24.•
Zurück zum Zitat Hoshino Y, Fu FH, Irrgang JJ, Tashman S. Can joint contact dynamics be restored by anterior cruciate ligament reconstruction? Clin Orthop Relat Res. 2013;471(9):2924–31. doi:10.1007/s11999-012-2761-1. This is another 2D–3D image matching method but this time using 3D-CT model and dynamic stereo x-ray, which allows short imaging times and high frame rates for more strenuous activities such as downhill running. Greater internal tibial rotation was associated with larger magnitude of sliding motion in the medial compartment during downhill running. The study also concluded that neither single bundle nor double bundle ACL reconstruction restored normal knee kinematics. CrossRefPubMedPubMedCentral Hoshino Y, Fu FH, Irrgang JJ, Tashman S. Can joint contact dynamics be restored by anterior cruciate ligament reconstruction? Clin Orthop Relat Res. 2013;471(9):2924–31. doi:10.​1007/​s11999-012-2761-1. This is another 2D–3D image matching method but this time using 3D-CT model and dynamic stereo x-ray, which allows short imaging times and high frame rates for more strenuous activities such as downhill running. Greater internal tibial rotation was associated with larger magnitude of sliding motion in the medial compartment during downhill running. The study also concluded that neither single bundle nor double bundle ACL reconstruction restored normal knee kinematics. CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Hoshino Y, Tashman S. Internal tibial rotation during in vivo, dynamic activity induces greater sliding of tibio-femoral joint contact on the medial compartment. Knee Surg Sports Traumatol Arthrosc. 2012;20(7):1268–75. doi:10.1007/s00167-011-1731-6.CrossRefPubMed Hoshino Y, Tashman S. Internal tibial rotation during in vivo, dynamic activity induces greater sliding of tibio-femoral joint contact on the medial compartment. Knee Surg Sports Traumatol Arthrosc. 2012;20(7):1268–75. doi:10.​1007/​s00167-011-1731-6.CrossRefPubMed
27.
Zurück zum Zitat Hoshino Y, Wang JH, Lorenz S, Fu FH, Tashman S. Gender difference of the femoral kinematics axis location and its relation to anterior cruciate ligament injury: a 3D-CT study. Knee Surg Sports Traumatol Arthrosc. 2012;20(7):1282–8. doi:10.1007/s00167-011-1738-z.CrossRefPubMed Hoshino Y, Wang JH, Lorenz S, Fu FH, Tashman S. Gender difference of the femoral kinematics axis location and its relation to anterior cruciate ligament injury: a 3D-CT study. Knee Surg Sports Traumatol Arthrosc. 2012;20(7):1282–8. doi:10.​1007/​s00167-011-1738-z.CrossRefPubMed
28.
Zurück zum Zitat Victor J, Van Doninck D, Labey L, Van Glabbeek F, Parizel P, Bellemans J. A common reference frame for describing rotation of the distal femur: a ct-based kinematic study using cadavers. J Bone Joint Surg (Br). 2009;91(5):683–90. doi:10.1302/0301-620X.91B5.21827.CrossRef Victor J, Van Doninck D, Labey L, Van Glabbeek F, Parizel P, Bellemans J. A common reference frame for describing rotation of the distal femur: a ct-based kinematic study using cadavers. J Bone Joint Surg (Br). 2009;91(5):683–90. doi:10.​1302/​0301-620X.​91B5.​21827.CrossRef
29.
Zurück zum Zitat Hoshino Y, Wang JH, Lorenz S, Fu FH, Tashman S. The effect of distal femur bony morphology on in vivo knee translational and rotational kinematics. Knee Surg Sport Traumatol Arthrosc. 2012;20(7):1331–8. doi:10.1007/s00167-011-1661-3.CrossRef Hoshino Y, Wang JH, Lorenz S, Fu FH, Tashman S. The effect of distal femur bony morphology on in vivo knee translational and rotational kinematics. Knee Surg Sport Traumatol Arthrosc. 2012;20(7):1331–8. doi:10.​1007/​s00167-011-1661-3.CrossRef
30.
Zurück zum Zitat Espregueira-Mendes J, Pereira H, Sevivas N, et al. Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device. Knee Surg Sport Traumatol Arthrosc. 2012;20(4):671–8. doi:10.1007/s00167-012-1914-9.CrossRef Espregueira-Mendes J, Pereira H, Sevivas N, et al. Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device. Knee Surg Sport Traumatol Arthrosc. 2012;20(4):671–8. doi:10.​1007/​s00167-012-1914-9.CrossRef
31.
Zurück zum Zitat Naraghi AM, Gupta S, Jacks LM, Essue J, Marks P, White LM. Anterior cruciate ligament reconstruction: MR imaging signs of anterior knee laxity in the presence of an intact graft. Radiology. 2012;263(3):802–10. doi:10.1148/radiol.12110779.CrossRefPubMed Naraghi AM, Gupta S, Jacks LM, Essue J, Marks P, White LM. Anterior cruciate ligament reconstruction: MR imaging signs of anterior knee laxity in the presence of an intact graft. Radiology. 2012;263(3):802–10. doi:10.​1148/​radiol.​12110779.CrossRefPubMed
33.
Zurück zum Zitat Vassalou EE, Klontzas ME, Kouvidis GK, Matalliotaki PI, Karantanas AH. Rotational knee laxity in anterior cruciate ligament deficiency: an additional secondary sign on MRI. Am J Roentgenol. 2016;206(1):151–4. doi:10.2214/AJR.15.14816.CrossRef Vassalou EE, Klontzas ME, Kouvidis GK, Matalliotaki PI, Karantanas AH. Rotational knee laxity in anterior cruciate ligament deficiency: an additional secondary sign on MRI. Am J Roentgenol. 2016;206(1):151–4. doi:10.​2214/​AJR.​15.​14816.CrossRef
34.
Zurück zum Zitat Yau WP, Fok AWM, Yee DKH. Tunnel positions in transportal versus transtibial anterior cruciate ligament reconstruction: a case-control magnetic resonance imaging study. Arthrosc - J Arthrosc Relat Surg. 2013;29(6):1047–52. doi:10.1016/j.arthro.2013.02.010.CrossRef Yau WP, Fok AWM, Yee DKH. Tunnel positions in transportal versus transtibial anterior cruciate ligament reconstruction: a case-control magnetic resonance imaging study. Arthrosc - J Arthrosc Relat Surg. 2013;29(6):1047–52. doi:10.​1016/​j.​arthro.​2013.​02.​010.CrossRef
35.
Zurück zum Zitat Noh JH, Roh YH, Yang BG, Yi SR, Lee SY. Femoral tunnel position on conventional magnetic resonance imaging after anterior cruciate ligament reconstruction in young men: transtibial technique versus anteromedial portal technique. Arthroscopy. 2013;29(5):882–90. doi:10.1016/j.arthro.2013.01.025.CrossRefPubMed Noh JH, Roh YH, Yang BG, Yi SR, Lee SY. Femoral tunnel position on conventional magnetic resonance imaging after anterior cruciate ligament reconstruction in young men: transtibial technique versus anteromedial portal technique. Arthroscopy. 2013;29(5):882–90. doi:10.​1016/​j.​arthro.​2013.​01.​025.CrossRefPubMed
36.
Zurück zum Zitat Schairer WW, Haughom BD, Morse LJ, Li X, Ma CB. Magnetic resonance imaging evaluation of knee kinematics after anterior cruciate ligament reconstruction with anteromedial and transtibial femoral tunnel drilling techniques. Arthrosc - J Arthrosc Relat Surg. 2011;27(12):1663–70. doi:10.1016/j.arthro.2011.06.032.CrossRef Schairer WW, Haughom BD, Morse LJ, Li X, Ma CB. Magnetic resonance imaging evaluation of knee kinematics after anterior cruciate ligament reconstruction with anteromedial and transtibial femoral tunnel drilling techniques. Arthrosc - J Arthrosc Relat Surg. 2011;27(12):1663–70. doi:10.​1016/​j.​arthro.​2011.​06.​032.CrossRef
37.
39.•
Zurück zum Zitat Zaid M, Lansdown D, Su F, et al. Abnormal tibial position is correlated to early degenerative changes one year following ACL reconstruction. J Orthop Res. 2015;33(7):1079–86. doi:10.1002/jor.22867. This study links tibiofemoral biomechanics to cartilage matrix composition in ACL reconstructed knees. T1ρ and T2 relaxation times for cartilage were calculated using 3D FSE sequences and T1ρ/T2 weighted images, while biomechanical measurements were calculated by 3D reconstruction of segmented bones. The study demonstrates how biomechanics has direct impact on cartilage matrix composition. CrossRefPubMed Zaid M, Lansdown D, Su F, et al. Abnormal tibial position is correlated to early degenerative changes one year following ACL reconstruction. J Orthop Res. 2015;33(7):1079–86. doi:10.​1002/​jor.​22867. This study links tibiofemoral biomechanics to cartilage matrix composition in ACL reconstructed knees. T1ρ and T2 relaxation times for cartilage were calculated using 3D FSE sequences and T1ρ/T2 weighted images, while biomechanical measurements were calculated by 3D reconstruction of segmented bones. The study demonstrates how biomechanics has direct impact on cartilage matrix composition. CrossRefPubMed
42.
44.
45.
Zurück zum Zitat Logan M, Dunstan E, Robinson J, Williams A, Gedroyc W, Freeman M. Tibiofemoral kinematics of the anterior cruciate ligament (ACL)-deficient weightbearing, living knee employing vertical access open “Interventional†multiple resonance imaging. Am J Sports Med. 2004;32(3):720–6. doi:10.1177/0095399703258771.CrossRefPubMed Logan M, Dunstan E, Robinson J, Williams A, Gedroyc W, Freeman M. Tibiofemoral kinematics of the anterior cruciate ligament (ACL)-deficient weightbearing, living knee employing vertical access open “Interventional†multiple resonance imaging. Am J Sports Med. 2004;32(3):720–6. doi:10.​1177/​0095399703258771​.CrossRefPubMed
47.
48.•
Zurück zum Zitat Lenhart RL, Kaiser J, Smith CR, Thelen DG. Prediction and validation of load-dependent behavior of the tibiofemoral and patellofemoral joints during movement. Ann Biomed Eng. 2015;43(11):2675–85. doi:10.1007/s10439-015-1326-3. This study combines information from both open and closed MRI scans and models the 3D reconstructed knee to a lower extremity model. By using simulations, the authors can measure joint biomechanics during movements, according to the muscle forces across the joints and surrounding soft tissue structures. These models may offer opportunities to calculate biomechanical parameters without having to acquire simultaneous images for various movements and tasks. CrossRefPubMed Lenhart RL, Kaiser J, Smith CR, Thelen DG. Prediction and validation of load-dependent behavior of the tibiofemoral and patellofemoral joints during movement. Ann Biomed Eng. 2015;43(11):2675–85. doi:10.​1007/​s10439-015-1326-3. This study combines information from both open and closed MRI scans and models the 3D reconstructed knee to a lower extremity model. By using simulations, the authors can measure joint biomechanics during movements, according to the muscle forces across the joints and surrounding soft tissue structures. These models may offer opportunities to calculate biomechanical parameters without having to acquire simultaneous images for various movements and tasks. CrossRefPubMed
49.
50.
51.
Zurück zum Zitat Furumatsu T, Miyazawa S, Tanaka T, Okada Y, Fujii M, Ozaki T. Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction. Int Orthop. 2014;38(7):1393–9. doi:10.1007/s00264-013-2238-1.CrossRefPubMed Furumatsu T, Miyazawa S, Tanaka T, Okada Y, Fujii M, Ozaki T. Postoperative change in medial meniscal length in concurrent all-inside meniscus repair with anterior cruciate ligament reconstruction. Int Orthop. 2014;38(7):1393–9. doi:10.​1007/​s00264-013-2238-1.CrossRefPubMed
52.
53.
Zurück zum Zitat Biercevicz AM, Akelman MR, Fadale PD, et al. MRI volume and signal intensity of ACL graft predict clinical, functional, and patient-oriented outcome measures after ACL reconstruction. Am J Sports Med. 2015;43(3):693–9. doi:10.1177/0363546514561435.CrossRefPubMed Biercevicz AM, Akelman MR, Fadale PD, et al. MRI volume and signal intensity of ACL graft predict clinical, functional, and patient-oriented outcome measures after ACL reconstruction. Am J Sports Med. 2015;43(3):693–9. doi:10.​1177/​0363546514561435​.CrossRefPubMed
55.
Zurück zum Zitat Sutter EG, Widmyer MR, Utturkar GM, Spritzer CE, Garrett WE, DeFrate LE. In vivo measurement of localized tibiofemoral cartilage strains in response to dynamic activity. Am J Sports Med. 2015;43(2):370–6. doi:10.1177/0363546514559821.CrossRefPubMed Sutter EG, Widmyer MR, Utturkar GM, Spritzer CE, Garrett WE, DeFrate LE. In vivo measurement of localized tibiofemoral cartilage strains in response to dynamic activity. Am J Sports Med. 2015;43(2):370–6. doi:10.​1177/​0363546514559821​.CrossRefPubMed
57.
58.
Zurück zum Zitat Neuman P, Owman H, Müller G, Englund M, Tiderius CJ, Dahlberg LE. Knee cartilage assessment with MRI (dGEMRIC) and subjective knee function in ACL injured copers: a cohort study with a 20 year follow-up. Osteoarthr Cartilage. 2014;22(1):84–90. doi:10.1016/j.joca.2013.10.006.CrossRef Neuman P, Owman H, Müller G, Englund M, Tiderius CJ, Dahlberg LE. Knee cartilage assessment with MRI (dGEMRIC) and subjective knee function in ACL injured copers: a cohort study with a 20 year follow-up. Osteoarthr Cartilage. 2014;22(1):84–90. doi:10.​1016/​j.​joca.​2013.​10.​006.CrossRef
Metadaten
Titel
Functional knee assessment with advanced imaging
verfasst von
Keiko Amano
Qi Li
C. Benjamin Ma
Publikationsdatum
06.04.2016
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 2/2016
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-016-9340-0

Weitere Artikel der Ausgabe 2/2016

Current Reviews in Musculoskeletal Medicine 2/2016 Zur Ausgabe

Elbow Soft Tissue Surgery (L Oh, Section Editor)

Ulnar neuropathy: evaluation and management

Elbow Soft Tissue Surgery (L Oh, Section Editor)

Distal biceps ruptures: open and endoscopic techniques

ELBOW SOFT TISSUE SURGERY (L OH, SECTION EDITOR)

Posterolateral rotatory instability of the elbow

ACL Update: Objective Measures on Knee Instability (V Musahl, Section Editor)

Knee instability scores for ACL reconstruction

ACL Update: Objective Measures on Knee Instability (V Musahl, Section Editor)

Assessment of the pivot shift using inertial sensors

ACL Update: Objective Measures on Knee Instability (V Musahl, Section Editor)

ACL update: objective measures on knee instability: an introduction

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.