Ligament Injuries Of Knee Joint Research Articles

Magnetic Resonance Imaging in diagnosing anterior and posterior cruciate ligament injury of knee joint with arthroscopic correlation

Anterior and posterior cruciate ligaments are the most injured of the major knee ligaments. Magnetic Resonance Imaging (MRI) knee is routinely used to diagnose or support clinical diagnosis for cruciate ligament tear before arthroscopic treatment. MRI of the knee has been regarded as the non-invasive alternative to diagnostic arthroscopy, which is regarded as the gold standard for the diagnosis of traumatic intra-articular knee injuries. A cross-sectional study was carried out in the Department of Radiology in collaboration with Orthopedics among 55 patients with clinically suspected anterior and posterior cruciate ligament injury using the purposive sampling method. MRI diagnosis of anterior and posterior cruciate ligaments tear correlated significantly well with arthroscopic diagnosis as shown by the higher validity test results with 90.91% sensitivity, 97.73% specificity, 96.36% accuracy, 90.91% positive predictive value, and 97.73% negative predictive value. The study also revealed that there is no statistically significant difference (p =0.62) between MRI and arthroscopy in the evaluation of cruciate ligament tears. Therefore, MRI is a reliable tool and non-invasive diagnostic modality in the evaluation of anterior and posterior cruciate ligament tears before surgical management of these cases.

Correlation of magnetic resonance imaging findings and arthroscopy findings in diagnosis of intra articular ligament injuries of knee joint

Background: The knee is the largest synovial joint in body with extra and intra articular ligaments which act as supporting structures around the joint. The intra articular ligaments of knee are more commonly injured. An accurate and early diagnosis of the internal derangement of knee is necessary for planning the treatment. In this study we compare the findings of magnetic resonance imaging (MRI) with arthroscopy and evaluate the accuracy of MRI in diagnosing intra-ligament injuries of knee. Methods: It is a prospective study conducted in the department of orthopaedics, Raja Rajeswari medical college and hospital, Bangalore from July 2018 to May 2021. Selection criteria include 80 patients who presented with history of ligamentous injury to the knee. The MRI was obtained and selected cases were posted for arthroscopic surgery after obtaining the informed consent. The MRI findings and Arthroscopy findings were correlated and statistical data analysis is prepared to obtain accuracy of MRI. Results: In this study 80 patients were selected and data was prepared. ACL tear presented with 100% sensitivity and 95% accuracy, PCL injuries shows 100% sensitivity and 97% accuracy, medial meniscus tears presented with sensitivity 96.15% and accuracy 95%, lateral meniscus tears presented with sensitivity 95.83% and accuracy 97.50% of MRI. Conclusions: In our study the MRI has more capable in detecting anterior horn tears, multiple tears and underneath tears that may be overlooked in arthroscopy. However, appropriate sequences, analysed in different planes, newer techniques, powerful tomograms will improve the diagnostic accuracy and reduce errors.

Evaluation of the Anterior Cruciate Ligament Injury of Knee Joint Using Magnetic Resonances Imaging

Anterior cruciate ligament (ACL) injury is a common indication for Magnetic Resonance imaging examination, the advancements in Magnetic Resonance imaging have provided the considerable potential for a one-stop shop radiation-free assessment with an all-in-one modality examination of the knee joint. The aim of this study is to the evaluation of the anterior cruciate ligament injury of the knee joint using magnetic resonance imaging. A study was performed to evaluate meniscal and anterior cruciate

A basic study for the molecular imaging of dual-energy CT in diagnosing anterior cruciate ligament injury of knee joint.

Anterior cruciate ligament (ACL) injury is a common disease in clinical practice that seriously affects the daily life of patients. To explore the molecular imaging basis of "diminution sign on dual-energy colour mapping" for the diagnosis of ACL injury by dual-energy computed tomography (DECT). The hydroxylysine and hydroxyproline reagents were prepared in different concentrations. The grouping was shown as follows: a simple concentration change group of an amino acid (group 1/2); a mixed solution group with the concentration increasing synchronously (group 3); a mixed solution group with the concentration reverse increasing and decreasing (group 4); and a mixed solution group that fix one amino acid with increasing concentration of the other (group 5/6). The samples were scanned by DECT. The solution CT value and image signal-to-noise ratio were analyzed. In group 1/2, the brightness of the dual-energy color mapping of each test tube solution and the CT value increased with increasing the concentration of amino acid. In group 6, there was no significant change in the brightness and brilliance of the dual-energy color mapping and the CT value. The remaining three groups showed an increase in the brightness and brilliance of the dual-energy color mapping and the CT value, and this increase was positively associated with the hydroxylysine concentration. The dual-energy staining of the DECT imaging in "tendon" mode is related to hydroxylysine and hydroxyproline. Moreover, the degree of dual-energy color mapping is positively correlated with the change of CT value.

Analysis of Visual Risk Factors of Anterior Cruciate Ligament Injury of Knee Joint.

This study aimed to explore whether the defect of visual function is a risk factor of knee anterior cruciate ligament (ACL) sports injury and to provide a theoretical basis for the primary prevention of ACL sports injury. This cross-sectional study included 392 participants divided into two groups: the sports injury group (287 with sports injury of knee) and the control group (105 healthy volunteers). Participants in the sports injury group were further divided into the ACL-Intact group (133) and the ACL-Deficient group (154). Participants in the sports injury group received a questionnaire about the conditions of their injury (including injury action, site condition, weather, contact) and a visual examination by synoptophore (including binocular vision, subjective and objective oblique angle, visual fusion range, stereoacuity). Participants in the control group only received the visual examination. In the end, we found that low visual fusion range (p = 0.003) and injury action, especially quick turn (p = 0.001), sudden stop (p < 0.001) and jump (p = 0.001), are the major risk factors for ACL injury in the analysis of the integrated data. In addition, athletes with low vision fusion range have increased risk of ACL sports injury when they make a sudden stop on wooden floor, plastic floor or cement floor on cloudy days (OR = 13.208). Visual factors, especially low fusion range, significantly increase the risk of ACL sports injury.

Evaluation and diagnosis of knee joint diagonal lesion and surgical strategy and effectiveness

To investigate the evaluation, diagnosis, and surgical treatment of knee joint diagonal lesion and to observe its effectiveness. A retrospective analysis was performed on 9 patients with knee joint diagonal lesion admitted between November 2011 and November 2019, including 7 males and 2 females, aged 18-61 years, with an average age of 38.3 years. According to the clinical staging criteria of multiple ligament injury of knee joint, 6 patients with acute stage injury (≤3 weeks), the time from injury to operation was 5-16 days, with an average of 9.3 days; 3 patients with old stage injury (>3 weeks), the time from injury to operation was 7, 12, 144 months, respectively. Posterolateral complex injuries were all type C according to Fanelli classification, and the posterior cruciate ligament injury was grade 3 according to American Medical Association (AMA) classification. According to the three columns classification of tibial plateau fracture, there were 2 cases of zero column fracture and 7 cases of medial column fracture. Patients with acute injury were treated with posterior cruciate ligament reconstruction, posterolateral complex repair and/or reinforcement reconstruction, and tibial plateau fracture was treated with conservative treatment or internal fixation. Patients with malunion of tibial plateau in old stage were treated with limited osteotomy, bone grafting, and internal fixation; the stability of the knee joint was further evaluated during operation, then the posterior cruciate ligament reconstruction and/or posterolateral complex repair and reconstruction were performed as needed. Lysholm score and the International Knee Documentation Committee (IKDC) score before and after operation were used to evaluate knee function and effectiveness. All patients were followed up 24-119 months, with an average of 51.7 months. All the incisions healed by first intention, and no complication such as incision infection, deep venous thrombosis of lower extremities occurred, and there was no reoperation during follow-up. The full-length X-ray films of both lower extremities at 6 months and 1, 2 years after operation showed that the alignment of both lower extremities returned to normal, and the stress position X-ray films showed that the stability in all directions recovered well. The X-ray films of the knee joint at 6 months after operation showed that the fracture of the tibial plateau healed well. At 1 year after operation, MRI showed that the signal of the repaired and reconstructed ligament was good, and there was no reconstruction failure such as ligament absorption or rupture occurred. At 1 year after operation, the muscle strength of the affected limbs was all rated as grade Ⅴ, and the active and passive range of motion of the knee joint recovered to 0°-130°. At 2 years after operation, the Lysholm score and IKDC score significantly improved when compared with those before operation (P<0.05). Knee joint diagonal lesion is a special type of posterior cruciate ligament and posterolateral complex injury with anteromedial split and collapse fracture of tibial plateau, which requires correct evaluation and diagnosis of the injured structure, and detailed surgical and rehabilitation programs to achieve better effectiveness.

Comparison of clinical examination &amp; MRI against arthroscopy in diagnosis of Meniscal and anterior cruciate ligament injuries of knee joint

Introduction: The most frequent internal instability of the knee is a meniscal tear. Most cost-effective and the primary diagnostic method is a physical examination of the knee joint. MRI is a non-invasive and extremely sensitive method of study and it frequently detects subtle and early alterations in the soft tissues. Arthroscopy is a highly specific and sensitive method which is useful for both diagnosis and treatment but it is an invasive treatment. Objective 1. To assess the accuracy for clinical examination and arthroscopy to diagnose the anterior cruciate ligament and meniscal injuries in knee joint. 2. To examine how accurate MRI is, as compared to arthroscopy in diagnosing anterior cruciate ligament and meniscal injuries in knee. 3. Anassociation of diagnostic accuracy of MRI and clinical examination in diagnosis of anterior cruciate ligament and meniscal injuries in knee joint. Material and Methods: A Cross-sectional study conducted at Department of Orthopedic Surgery, Services Institute of Medical Sciences (SIMS). This study completed in one year and two months after the acceptance of synopsis. A sample of 120 patients was calculated for this study. A clinical diagnosis of meniscal, posterior cruciate ligament, anterior cruciate ligament, lateral collateral ligament, and medial collateral ligament injury of the knee has made after these patients gave their up-to-date consent. These patients were evaluated on the basis of MRI and Arthroscopy. We used SPSS to evaluate all data, with arthroscopy serving as the gold standard. Results: The study contained 120 patients. The mean age of these patients is between 30.8 ± 6.93 years. Most of the patients are male. The most common ligament involved in this study found to be ACL followed by medial Meniscal injury. Findings from clinical examination are correlated with Arthroscopic findings and it found more sensitive for ACL injuries (97.5%) while it is most specific for ACL as well as Medial Meniscal injuries (100%). Findings from MRI are also correlate with Arthroscopy, MRI found most sensitive to detect ACL injuries (95.8%) and it is most specific for ACL injuries also (100%). We also compare the MRI findings with clinical examination finding and found that, clinical examination is almost equally accurate as MRI to detect the injuries of ACL injuries with sensitivity of clinical examination 97.5% and MRI 95.8% and found 100% for ACL injuries. Conclusion: We concluded that the clinical examination is batter for diagnosing cruciate ligamentous injury while MRI is batter for diagnosis of meniscal injury, in case of knee injuries. So we may skip MRI for patients with cruciate injury &amp;directly proceed towards arthroscopy. In difficult cases and the cases which are involving meniscal injury both MRI and arthroscopy may be considered. Keywords: Meniscal tear; MRI; Arthroscopy; knee joint; clinical examination.

MRI Assessment of Anterolateral Ligament Injury of Knee Joint

Clinical diagnosis of the anterolateral ligament (ALL) insufficiency is rather complicated. Accordingly, it is necessary to use MRI for accurate diagnosis in patients with complex anterolateral instability of knee joint. The purpose of our work was to determine the possibilities of MRI in the diagnosis of anterolateral ligament lesions. A retrospective analysis of 224 MRI studies of patients with ACL injuries was performed. 107 studies were performed on a 3.0 Tesla device and 117 studies were performed on a 1.5 Tesla device. In 29 cases (13%), it was impossible to visualize ALL on MRI, so these patients were excluded from the study, while 195 patients (87%) remained in the study. 128 (65.6%) of the 195 remaining patients did not show signs of ALL rupture, while 67 patients (34.4%) had sings of rupture. In the group with ALL lesions, the femoral part was injured in 50.7% (34 patients), the tibial part in 19.4% (13 patients), and the middle part in 29.9% (20 patients). 1. In our study, we determined that the ALL was visualized in 87% of patients with ACL injury. 2. In our patients' group, the frequency of a concomitant ALL lesion together with an ACL lesion was 34.4%, when an MRI study was performed up to 6 weeks from the moment of trauma.

Functional evaluation of anterior cruciate ligament reconstruction with anatomical single bundle technique using quadrupled hamstring tendon

Objective: Anterior cruciate ligament injury is one of the commonest ligament injuries of knee joint. Arthroscopic acl reconstruction is indicated if patient presents with knee instability and wants to get back to active life style. Incidence of meniscal and chondral injuries is high in chronic acl injured knees .There is still debate on ideal acl reconstruction graft choice, graft fixation methods and tunnel making techniques. So we conducted an observational study on functional evaluation of arthroscopic acl reconstruction using single bundle of quadrupled hamstring graft fixed with endobutton at femoral side and with interference screw at the tibial side using transportal technique. Materials and methods: Arthroscopic acl reconstructed adult patients less than 60 years were included in the study. Those acl injuries in children and older patients with osteoarthritic changes and associated bony injury patients were excluded from the study. Results: There were 40 cases in the study with age ranging from 20 to 47 years with mean age of 31 years. Sports was the most common mode of injury. Isolated acl injury was found in 62.5 percent of cases and combined meniscus injury along with acl injury was found in 37.5 percent of cases in the study. Partial menisectomy was done in 90 percent of cases while meniscus repair was done in 10 percent of cases. The time period from injury to surgery varies from one week to one year with mean time of 3 months. Patients were followed up for a minimum period of one year and evaluated with Lysholm score. The maximum score achieved was 95 and minimum score was 71. There is statiscal significance between pre and postoperative lysholm scores and between associated knee injures and lysholm score. All patients were able to return to their previous job at four months. Conclusion: Arthroscopic Acl reconstruction with quadrupled hamstring graft fixed at anatomical site with endobutton at femoral side and with interference screw at tibial side leads to reproducible good functional results with minimum morbidity and helps patients get back to their previous job. Keywords: arthroscopic acl reconstruction, hamstring tendon, endobutton

Role of MRI in the Diagnosis of Meniscal and Ligament Injuries of Knee Joint: A Retrospective Study

Role of MRI in the Diagnosis of Meniscal and Ligament Injuries of Knee Joint: A Retrospective Study

A Cross Sectional Study to Evaluate Role of Magnetic Resonance Imaging in Ligament Injuries of Knee Joint in a Tertiary Healthcare Institute

A Cross Sectional Study to Evaluate Role of Magnetic Resonance Imaging in Ligament Injuries of Knee Joint in a Tertiary Healthcare Institute

Preliminary Evaluation on Meniscal and Different Functional Splitting of Anterior Cruciate Ligament Injuries of Knee Joint in Rabbit Models

The diagnosis, treatment and efficacy evaluation of anterior cruciate ligament (ACL) partly jury is controversy. We established the models of different damage to functional bundle, which is used on the ACL of rabbit knee, and analyzed the impact of different damage to functional bundle on ACL. 45 New Zealand, white rabbits were randomly divided into three groups, anteromedial bundle (AMB) fracture group, posterolateral bundle (PLB) fracture group and no fracture group. When finishing building the models, 8 rabbits were killed randomly on the second, fourth and eighth week respectively. Finally, we can observe the general form of the meniscus through experimental HE staining. The two groups were similar to the general form. In addition, the surface was unsmooth in the HE staining experiment and the tissues were loose as well as collagen fibers of varying thickness. It is believed that it will cause meniscus regression along with the ruin of different functional bundle on the ACL.

Diagnostic Accuracy of Magnetic Resonance Imaging in Anterior Cruciate Ligament Injuries of Knee Joint, in Comparison With Arthroscopy

Diagnostic Accuracy of Magnetic Resonance Imaging in Anterior Cruciate Ligament Injuries of Knee Joint, in Comparison With Arthroscopy

Relaxing needling combined with rehabilitation training for medial collateral ligament injury of knee joint

To compare the clinical efficacy differences between relaxing needling combined with rehabilitation training and rehabilitation training alone for medial collateral ligament (MCL) injury of knee joint. Sixty cases of MCL injury were randomly assigned into an observation group (30 cases, one case dropping out) and a control group (30 cases, two cases dropping out). Patients in the control group were treated with rehabilitation training; based on the treatment of control group, patients in the observation group were additionally treated with relaxing needles at ashi points, Heding (EX-LE 2), Neixiyan (EX-LE 4), Dubi (ST 35), Yanglingquan (GB 34), Liangqiu (ST 34), etc. The treatment was given once a day; six treatments were taken as one course, and totally four courses were given. The visual analogue scale (VAS), Lysholm knee function score and clinical efficacy before and after treatment were evaluated; also the safety was evaluated. After treatment, VAS scores were apparently reduced and the Lysholm scores were obviously increased in the two groups (all P<0.001). The improvement of VAS and Lysholm scores in the observation group were superior to that in the control group (both P<0.05). The effective rate was 93.1% (27/29) in the observation group, which was superior to 71.4% (20/28) in the control group (P<0.05). During the treatment, no adverse events occurred in the two groups. Relaxing needling combined with rehabilitation training can effectively improve the swel-ling, pain and other symptoms of MCL injury, which is superior to rehabilitation training alone.

English

BACKGROUND: This study is to determine the importance of Clinical Examination, MRI and Arthroscopy findings of one over the other respectively, in assessing meniscal & ligament injury of knee joint. Knee joint is one of the most commonly injured joints because of its anatomical structure, its exposures to external forces and the functional demands placed on it. In the last four decades advances in understanding and treatment of knee instability have progressed at a rapid rate. Historically several investigations have shown that clinical diagnosis is approximately 70% accurate in diagnosing knee pathology. STUDY DESIGN: This is an objective study in which, patients with complaints of pain and instability of knee attending to the Department of Orthopaedics, Malla Reddy Hospital (MRH) attached to Malla Reddy Institute of Medical Sciences (MRIMS), Surarum, Hyderabad, were studied. More than 200 patients who have reported to the outpatient department between 1st January 2012 and 31st August 2012, of which 50 patients underwent clinical examination, MRI and Arthroscopic evaluation. RESULTS: All the 10 cases of isolated ACL injury and one case of only PCL injury, one case of both ACL & PCL injury, there was equal correlation between Clinical, MRI & Arthroscopy. Two PCL and bicruciate ligaments were diagnosed clinically, MRI and Arthroscopy. In both meniscal and cruciate ligament injuries 32 cases were diagnosed by clinical examination, out of which Arthroscopically 26 were diagnosed and 28 were diagnosed by MRI. In isolated meniscal injured there were five diagnosed on arthroscopy, eight on clinical examination & four on MRI. Five were misdiagnosed clinically but on arthroscopy had no tear. CONCLUSION: From our study we concluded that, for isolated ACL and PCL injuries Clinical, MRI and Arthroscopy are almost equal in diagnosing the condition. For Meniscal injuries the sensitivity was