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Evaluating rotational kinematics of the knee in ACL-ruptured and healthy patients using 3.0 Tesla magnetic resonance imaging

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Rotational knee laxity is an important measure in restoring knee stability following anterior cruciate ligament (ACL) injury, but is difficult to quantify with current clinical tools. The hypothesis of the study is that there is greater tibial rotation (TR) in women than men, and also in ACL-deficient than healthy knees.

Methods

Sixteen healthy (8 men, 26.8 ± 6.4 years; 8 women, 26.9 ± 3.8 years) and ten ACL-deficient (5 men, 33.6 ± 10.5 years; 5 women, 36.3 ± 10.7 years) subjects received bilateral knee MRI in 15° of flexion using a custom device to apply a constant axial compressive load (44 N). A rotational torque (3.35 Nm) was sequentially applied to obtain images at internal and external rotation positions. T 2-weighted images were acquired in internal and external rotation. Images were segmented and TR was calculated. To assess reproducibility, six knees were scanned twice on separate days. Group comparisons were made with unpaired t tests, while intrasubject comparisons were made using paired t tests.

Results

Healthy women demonstrated greater TR than men (13.6° ± 4.7° vs. 8.3° ± 3.6°; P = 0.001). Male ACL-deficient knees showed greater TR than the contralateral knee (15.7° ± 6.9° vs. 7.7° ± 5.6°; P = 0.003), and compared to male controls (P = 0.002). ACL-deficient women showed greater TR compared to their contralateral leg (15.1° ± 2.3° vs. 10.0° ± 4.3°; P = 0.01). The intraclass correlation coefficient of the TR measurement was 0.913, and the SEM = 1.1°.

Conclusions

Kinematic MRI is a reproducible method to quantify total knee rotation. Women have more rotational laxity than men, particularly in the external rotation position. ACL rupture leads to increased rotational laxity of the knee.

Level of evidence

Retrospective case–control series, Level III.

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Authors and Affiliations

  1. School of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA

    Bryan D. Haughom & William W. Schairer

  2. Musculoskeletal Quantitative Imaging Research, Department of Radiology, UCSF, San Francisco, CA, USA

    Richard Souza & Xiaojuan Li

  3. Department of Orthopaedic Surgery, San Francisco School of Medicine, University of California, 500 Parnassus Ave, MU 320 W, San Francisco, CA, 94143-0728, USA

    C. Benjamin Ma

Authors
  1. Bryan D. Haughom
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  2. Richard Souza
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  5. C. Benjamin Ma
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Correspondence to C. Benjamin Ma.

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Haughom, B.D., Souza, R., Schairer, W.W. et al. Evaluating rotational kinematics of the knee in ACL-ruptured and healthy patients using 3.0 Tesla magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc 20, 663–670 (2012). https://doi.org/10.1007/s00167-011-1809-1

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