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Description of an evaluation system for knee kinematics in ligament lesions, by means of optical tracking and 3D tomography.

ABSTRACT: To describe and demonstrate the viability of a method for evaluating knee kinematics, by means of a continuous passive motion (CPM) machine, before and after anterior cruciate ligament (ACL) injury.This study was conducted on a knee from a cadaver, in a mechanical pivot-shift simulator, with evaluations using optical tracking, and also using computed tomography.This study demonstrated the viability of a protocol for measuring the rotation and translation of the knee, using reproducible and objective tools (error < 0.2 mm). The mechanized provocation system of the pivot-shift test was independent of the examiner and always allowed the same angular velocity and traction of 20 N throughout the movement.The clinical relevance of this method lies in making inferences about the in vivo behavior of a knee with an ACL injury and providing greater methodological quality in future studies for measuring surgical techniques with grafts in relatively close positions.

SUBMITTER: Fernandes TL

PROVIDER: S-EPMC4487496 | biostudies-other | 2014 Sep-Oct

REPOSITORIES: biostudies-other

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Description of an evaluation system for knee kinematics in ligament lesions, by means of optical tracking and 3D tomography.

Fernandes Tiago Lazzaretti TL Ribeiro Douglas Badillo DB da Rocha Diogo Cristo DC Albuquerque Cyro C Pereira César Augusto Martins CA Pedrinelli André A Hernandez Arnaldo José AJ

Revista brasileira de ortopedia 20140828 5

<h4>Objective</h4>To describe and demonstrate the viability of a method for evaluating knee kinematics, by means of a continuous passive motion (CPM) machine, before and after anterior cruciate ligament (ACL) injury.<h4>Methods</h4>This study was conducted on a knee from a cadaver, in a mechanical pivot-shift simulator, with evaluations using optical tracking, and also using computed tomography.<h4>Results</h4>This study demonstrated the viability of a protocol for measuring the rotation and tra ...[more]

PMID: 26229854

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Project description:Anterior cruciate ligament (ACL) deficiency alters 6 degrees of freedom knee kinematics, yet only anterior translation and internal rotation have been the primary measures in previous studies.To compare the 6 degrees of freedom knee kinematics and the graft forces after single- and double-bundle ACL reconstructions under various external loading conditions.Controlled laboratory study.Ten human cadaveric knees were tested with a robotic testing system under 4 conditions: intact, ACL deficient, single-bundle reconstructed with a quadrupled hamstring tendon graft, and double-bundle reconstructed with 2 looped hamstring tendon grafts. Knee kinematics and forces of the ACL or ACL graft in each knee were measured under 3 loading conditions: an anterior tibial load of 134 N, a simulated quadriceps muscle load of 400 N, and combined tibial torques (10 N.m valgus and 5 N.m internal tibial torques) at 0 degrees , 15 degrees , 30 degrees , 60 degrees , and 90 degrees of knee flexion.The double-bundle reconstruction restored the anterior and medial laxities closer to the intact knee than the single-bundle reconstruction. However, the internal rotation of the tibia under the simulated quadriceps muscle load was significantly decreased when compared with the intact knee after both reconstructions, more so after double-bundle reconstruction (P < .05). The entire graft force of the double-bundle reconstruction was more similar to that of the intact ACL than that of the single-bundle reconstruction. However, the posterolateral bundle graft in the double-bundle reconstructed knee was overloaded as compared with the intact posterolateral bundle.The double-bundle reconstruction can better restore the normal anterior-posterior and medial-lateral laxities than the single-bundle reconstruction can, but an overloading of the posterolateral bundle graft can occur in a double-bundle reconstructed knee.Both single-bundle and double-bundle techniques cannot restore the rotational laxities and the ACL force distributions of the intact knee.

Project description:Background: There are currently no well-established criteria to guide return to sports (RTS) after anterior cruciate ligament reconstruction (ACLR). In this study, a new test battery consisting of subjective and objective tests, especially multiplanar knee kinematics assessment, was developed to aid RTS decision making after ACLR. Methods: This study was conducted with 30 patients who were assessed a mean of 9.2 ± 0.5 months after ACLR. All patients underwent complete evaluations of both lower limbs with four objective assessments [isokinetic, hop, knee laxity, and 6-degree of freedom (6DOF, angle: flexion-extension, varus-valgus, internal-external rotation; translation: anteroposterior, proximodistal, mediolateral) knee kinematics tests] and two subjective assessments [International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) questionnaires]. Limb symmetry indices (LSIs) of knee strength, hop distance, and range of motion (ROM) of knee kinematics were calculated. LSI ≥90%, IKDC scale score within the 15th percentile for healthy adults, and ACL-RSI score >56 were defined as RTS criteria. Results: Significant differences between affected and contralateral knees were observed in the quadriceps strength (p < 0.001), hamstring strength (p = 0.001), single hop distance (p < 0.001), triple hop distance (p < 0.001), and rotational ROM (p = 0.01). Only four patients fulfilled the overall RTS criteria. The percentages of patients fulfilling individual criteria were: quadriceps strength, 40%; hamstring strength, 40%; single hop distance, 30%; triple hop distance, 36.7%; knee ligament laxity, 80%; flexion-extension, 23.3%; varus-valgus rotation, 20%; internal-external rotation, 66.7%; anteroposterior translation, 20%; proximodistal translation, 33.3%; mediolateral translation, 26.7%; IKDC scale score, 53.3%; and ACL-RSI score, 33.3%. Conclusion: At an average of 9 months after ACLR, objectively and subjectively measured knee functional performance was generally unsatisfactory especially the recovery of knee kinematics, which is an important prerequisite for RTS.

Dataset Information

Description of an evaluation system for knee kinematics in ligament lesions, by means of optical tracking and 3D tomography.

Publications

Description of an evaluation system for knee kinematics in ligament lesions, by means of optical tracking and 3D tomography.

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