Abstract
PurposeUltrasound (US) examination of the medial joint space of the knee has played a subordinate diagnostic role up till now. The purpose of the present study was to describe mean values of medial joint width and to investigate the impact of gender, age, and body mass index (BMI) on medial joint laxity in healthy knees using modern, dynamic US in a standardized fashion in unloaded and standardized loaded conditions.MethodsA total of 65 subjects with 79 healthy knees were enrolled in this study. All volunteers underwent clinical examination of the knee. The medial knee joint width was determined using US in a supine position at 0° and 30° of knee flexion in unloaded and standardized loaded (= 15 Dekanewton, daN) conditions using a specific device. Mean values were described and correlations between medial knee joint width and gender, age, and BMI were assessed.ResultsThirty-two females and 33 males were enrolled in this study. The mean medial joint width in 0° unloaded was 5.7 ± 1.2 mm and 7.4 ± 1.4 mm loaded. In 30° of knee flexion, the mean medial joint width was 6.1 ± 1.1 mm unloaded and 7.8 ± 1.2 mm loaded. The average change between unloaded and loaded conditions in 0° was 1.7 ± 1.0 mm and in 30° 1.7 ± 0.9 mm. A significant difference between genders was evident for medial joint width in 0° and 30° of flexion in unloaded and loaded conditions (p < 0.05). With rising age, a significant increased change of medial joint space width between unloaded and loaded conditions could be demonstrated in 0° (p = 0.032). No significant correlation between BMI and medial joint width in US could be found.ConclusionMean values of medial joint width in unloaded and standardized loaded conditions using a fixation device could be demonstrated. Based on the results of this study, medial knee joint width in US is gender- and age-related in healthy knees. These present data may be useful for evaluating patients with acute or chronic pathologies to the medial side of the knee.Level of evidenceIII.
Highlights
The importance of the medial collateral ligament (MCL) as a primary stabilizer against valgus stress on the knee joint has been proven by numerous biomechanical studies [7, 19, 31]
Since the medial ligament complex is frequently affected by injuries [2, 4, 22, 30], research on the medial side of the knee has been centered around pathologic findings on the medial collateral ligament via magnetic resonance images (MRI) and clinical examinations [10, 16, 20]
A total of 65 subjects with 79 healthy knees were enrolled in this study
Summary
The importance of the medial collateral ligament (MCL) as a primary stabilizer against valgus stress on the knee joint has been proven by numerous biomechanical studies [7, 19, 31]. Since the medial ligament complex is frequently affected by injuries [2, 4, 22, 30], research on the medial side of the knee has been centered around pathologic findings on the medial collateral ligament via magnetic resonance images (MRI) and clinical examinations [10, 16, 20]. Fluoroscopic imaging of the knee under valgus stress can be used to assess medial knee instability [13, 25]. This might be a good alternative, especially using the currently introduced portable ultrasound devices
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