Magnetic Resonance Imaging of 3-Dimensional In Vivo Tibiofemoral Kinematics in Anterior Cruciate Ligament-Reconstructed Knees
Magnetic Resonance Imaging of 3-Dimensional In Vivo Tibiofemoral Kinematics in Anterior Cruciate Ligament-Reconstructed Knees
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DOI：
10.1016/j.arthro.2009.01.014
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发表时间：
2009-07-01
影响因子：
4.7
通讯作者：
Ma, C. Benjamin
中科院分区：
文献类型：
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作者：
Carpenter, R. Dana;Majumdar, Sharmila;Ma, C. Benjamin
目的：本研究的目的是使用磁共振成像（MRI）来确定前交叉韧带（ACL）重建后的三维膝关节运动学。方法：9例ACL重建和对侧膝关节在术后12 +/- 8个月进行了测试。在模拟负重条件下，在完全伸展和膝关节屈曲40度时进行MRI。使用基于MRI的三维模型分析股骨髁位置、胫骨旋转、接触面积和接触位置。结果如下：当膝关节完全伸展时，ACL重建膝关节的胫骨与对侧膝关节相比外旋3.6 ° ± 4.2 °。外旋是由于胫骨内侧前半脱位所致。膝关节屈曲40 °时，ACL重建膝关节和对侧膝关节的胫骨均内旋5.3 °。ACL重建膝关节和对侧膝关节之间的接触面积或接触位置没有显著差异。当从伸展运动到屈曲运动时，ACL重建膝关节的胫骨内旋比对侧膝关节多3.5 ° +/- 5.9 °。结论：ACL重建恢复了膝关节外侧的正常运动，但内侧没有，导致从完全伸展运动到40度屈曲时胫骨内部旋转增加。这些结果表明，ACL重建不能恢复膝关节内侧的正常运动学，这可能导致早期软骨退变。
Purpose: The purpose of this study was to use magnetic resonance imaging (MRI) to determine 3-dimensional knee kinematics after anterior cruciate ligament (ACL) reconstruction. Methods: Nine ACL-reconstructed and contralateral knees were tested 12 +/- 8 months after surgery. MRI was performed at full extension and 40 degrees of knee flexion under simulated weight-bearing conditions. Femoral condyle positions, tibial rotation, contact area, and contact location were analyzed by use of MRI-based 3-dimensional models. Results: When knees were fully extended, tibiae in ACL-reconstructed knees were externally rotated by 3.6 degrees +/- 4.2 degrees compared with contralateral knees. The external rotation was due to anterior subluxation of the medial side of the tibia. At 40 degrees of knee flexion, tibiae in ACL-reconstructed knees and contralateral knees were both internally rotated by 5.3 degrees. There were no significant differences in contact area or contact location between ACL-reconstructed and contralateral knees. When moving from extension to flexion, ACL-reconstructed knees exhibited 3.5 degrees +/- 5.9 degrees more internal tibial rotation than contralateral knees. Conclusions: Reconstruction of the ACL restored normal motion on the lateral side of the knee but not on the medial side, resulting in increased internal tibial rotation when moving from full extension to 40 degrees of flexion. These results suggest that ACL reconstruction does not restore normal kinematics on the medial side of the knee, which may lead to early cartilage degeneration.