2015 ISAKOS Biennial Congress ePoster #1270
Three-dimensional In Vivo Dynamic Motion Analysis of Anterior Cruciate Ligament Deficient Knees Using Single-Plane Fluoroscopy
Takayuki Murayama, MD, PhD, Joetsu JAPAN
Takashi Sato, MD, Niigata City JAPAN
Satoshi Watanabe, MD, Niigata City JAPAN
Osamu Tanifuji, MD, Niigata City JAPAN
Tomoharu Mochizuki, MD, Niigata JAPAN
Hiroshi Yamagiwa, MD, PhD, Niigata City JAPAN
Yoshio Koga, MD, Niigata City JAPAN
Go Omori, MD, Niigata City JAPAN
Naoto Endo, MD, Niigata City JAPAN
Niigata university, Niigata city, JAPAN
FDA Status Not Applicable
Summary: Results of our three dimensional dynamic motion analysis of anterior cruciate ligament deficient (ACLD) knees suggested that the ACLD knees exhibited impaired screw home movement and larger range of the anteroposterior translation of the medial femoral condyle soon after the injury, regardless of age, sex, and presence of a meniscal tear.
Three dimensional (3D)-2 dimensional (2D) registration has been used to measure in-vivo 3D dynamic knee kinematics, and abnormal motion of anterior cruciate ligament deficient (ACLD) knee has been reported. To date, however, few studies have shown a correlation between abnormal motion of ACLD knees and clinical factors that might affect it. The purposes of this study were (1) to compare the in-vivo kinematics of unilateral ACLD knees during squatting to that of the contralateral uninjured knees, using 3D-2D registration, and (2) to evaluate if there is a correlation between the motion of ACLD knees and clinical factors.
Materials And Methods
Thirty-four unilateral ACLD patients (13 male, 21 female) with a mean age of 21.6 years (range, 14–47 years) were enrolled in this study. The average time past injury was 9.3 months (range, 1–60 months). The 3D femoral and tibial models were reconstructed from the CT data. Knee motion during squatting from full extension to full flexion was recorded using single-plane fluoroscopy. The 3D-2D registration was used to determine the 3D relative motion between the femur and tibia. The anteroposterior (AP) translations of the medial and lateral femoral condyles (MFC and LFC) relative to the tibia were determined using the projection of the geometric center axis of the femur (GCA) onto the tibial axial plane. For both the ACLD and uninjured knees, we determined (1) AP locations and (2) ranges of the AP translations (AP ranges) of the MFC and LFC. Data on the AP locations and AP ranges were statistically analyzed by comparing the motion of the ACLD and uninjured knees, using unpaired t-test. Data was also analyzed by determining the correlations between several factors that might affect the outcome (e.g., age, sex, presence of a meniscal tear, time after injury) and the side-to-side differences of the parameters of the knee kinematics, using Spearman’s rank correlation coefficient and correlation ratio.
In the ACLD knees, the LFC was located significantly more posteriorly than that in the uninjured knees near full extension (p < 0.01), while the MFC did not show significant difference. The AP range of the MFC was significantly larger in the ACLD knees than in the uninjured knees (p < 0.01), while that of the LFC did not show significant difference. The side-to-side difference in both the AP location of the LFC and the AP range of the MFC had no correlation with the above mentioned factors that might affect the outcome.
Near full extension, the LFC translated posteriorly, and the screw home movement seemed to be impaired in the ACLD knees. The larger AP range of the MFC in the ACLD knees has possibilities to lead to secondary meniscus injury and degenerative change of articular cartilage. In most of the subjects, the ACLD knees exhibited abnormal motion soon after the injury, regardless of age, sex, and presence of a meniscal tear. The results indicated that the ACL might have an important role in maintaining stability and normal kinematics.