Skip to main content

An Advanced Device for Multiplanar Instability Assessment in MRI

  • Chapter
  • First Online:
Complex Knee Ligament Injuries

Abstract

Multiligament knee injuries have low incidence, however are very devastating and require special attention. New approaches in the diagnosis are vital to allows a better assessement of associated lesions, more careful treatment planning and objective follow-up. The Porto-Knee Testing Device (PKTD) shows very promising results in the assessment of knee instability. The goal of the PKTD is to provide both anatomical and functional evaluation of the knee. It is able to carefully assess the knee sagittal and rotational stability. In multiligament injuries, the use of a arthrometric device concomitantly with imaging procedures can provide valuable information for surgical planning and stability restoration procedures. It is also possible in the postoperative follow-up to evaluate residual instability. Herein, we discuss the recent developments related to PKTD in diagnosis of knee ligament lesions and instability assessment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rihn JA, Cha PS, Groff YJ, Harner CD. The acutely dislocated knee: evaluation and management. J Am Acad Orthop Surg. 2004;12:334–46.

    Article  Google Scholar 

  2. Andrade R, Vasta S, Sevivas N, Pereira R, Leal A, Papalia R, et al. Notch morphology is a risk factor for ACL injury: a systematic review and meta-analysis. J ISAKOS. 2016;1:70–81.

    Article  Google Scholar 

  3. Fernandes MS, Pereira R, Andrade R, Vasta S, Pereira H, Pinheiro JP, et al. Is the femoral lateral condyle’s bone morphology the trochlea of the ACL? Knee Surg Sports Traumatol Arthrosc. 2017;25:207–14.

    Article  Google Scholar 

  4. Pereira HFC, Fernandes M, Pereira R, Jones H, Vasconcelos J, Oliveira J, et al. ACL injuries identifiable for pre-participation imagiological analysis: risk factors. In: Doral MN, Karlsson J, editors. Sports injuries: prevention, diagnosis, treatment and rehabilitation: Springer; 2014. p. 1–15.

    Google Scholar 

  5. Andrade R, Pereira H, Espregueira-Mendes J. ACL treatment in 2016–controversy and consensus. Asian J Arthrosc. 2016;1:3–10.

    Google Scholar 

  6. Pereira H, Gomes S, Silva L, Cunha A, Oliveira JM, Reis RL, et al. Fundamentals on injuries of knee ligaments in footballers. In: Olivera JM, Reis RL, editors. Regenerative strategies for the treatment of knee joint disabilities: Springer; 2017. p. 289–321.

    Google Scholar 

  7. Heijink A, Gomoll AH, Madry H, Drobnič M, Filardo G, Espregueira-Mendes J, et al. Biomechanical considerations in the pathogenesis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2012;20:423–35.

    Article  Google Scholar 

  8. Vannini F, Spalding T, Andriolo L, Berruto M, Denti M, Espregueira-Mendes J, et al. Sport and early osteoarthritis: the role of sport in aetiology, progression and treatment of knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2016;24:1786–96.

    Article  CAS  Google Scholar 

  9. Espregueira-Mendes J, Pereira R, Monteiro A, Pereira H, Sevivas N, Varanda P. Sports and anterior cruciate lesions. Revue de Chirurgie Orthopédique et Traumatologique. 2011;97:S472–S6.

    Article  Google Scholar 

  10. Ohashi B, Ward J, Araujo P, Kfuri M, Pereira H, Espregueira-Mendes J, et al. Partial anterior cruciate ligament ruptures: knee laxity measurements and pivot shift. In: Doral MN, Karlsson J, editors. Sports injuries: prevention, diagnosis, treatment and rehabilitation: Springer; 2015. p. 1245–58.

    Google Scholar 

  11. Skendzel JG, Sekiya JK, Wojtys EM. Diagnosis and management of the multiligament-injured knee. J Orthop Sports Phys Ther. 2012;42:234–42.

    Article  Google Scholar 

  12. Carroll KM, Gregory Cvetanovich M, Heyworth BE, Van de Velde S, Gill TJ IV. Approach to management of the patient with the multiligament-injured knee. Pain. 2013:15.

    Google Scholar 

  13. Gimber LH, Scalcione LR, Rowan A, Hardy JC, Melville DM, Taljanovic MS. Multiligamentous injuries and knee dislocations. Skelet Radiol. 2015;44:1559–72.

    Article  Google Scholar 

  14. Giaconi JC, Allen CR, Steinbach LS. Anterior cruciate ligament graft reconstruction: clinical, technical, and imaging overview. Top Magn Reson Imaging. 2009;20:129–50.

    Article  Google Scholar 

  15. Robertson PL, Schweitzer ME, Bartolozzi AR, Ugoni A. Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology. 1994;193:829–34.

    Article  CAS  Google Scholar 

  16. Tung GA, Davis L, Wiggins M, Fadale P. Tears of the anterior cruciate ligament: primary and secondary signs at MR imaging. Radiology. 1993;188:661–7.

    Article  CAS  Google Scholar 

  17. Winters K, Tregonning R. Reliability of magnetic resonance imaging of the traumatic knee as determined by arthroscopy. N Z Med J. 2005;118

    Google Scholar 

  18. Pereira H, Gomes S, Vasconcelos JC, Soares L, Pereira R, Oliveira JM et al. MRI laxity assessment. In: Musahl V, Karlsson J, Kuroda R, Zaffagnini S. Rotatory knee instability. Springer; 2017. p. 49–61.

    Google Scholar 

  19. Behairy NH, Dorgham MA, Khaled SA. Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy. Int Orthop. 2009;33:961–7.

    Article  Google Scholar 

  20. Rubin DA, Kettering JM, Towers J, Britton C. MR imaging of knees having isolated and combined ligament injuries. AJR Am J Roentgenol. 1998;170:1207–13.

    Article  CAS  Google Scholar 

  21. Forster I, Warren-Smith C, Tew M. Is the KT1000 knee ligament arthrometer reliable? Bone Joint J. 1989;71:843–7.

    CAS  Google Scholar 

  22. Graham G, Johnson S, Dent C, Fairclough J. Comparison of clinical tests and the KT1000 in the diagnosis of anterior cruciate ligament rupture. Br J Sports Med. 1991;25:96–7.

    Article  CAS  Google Scholar 

  23. Dejour D, Ntagiopoulos PG, Saggin PR, Panisset J-C. The diagnostic value of clinical tests, magnetic resonance imaging, and instrumented laxity in the differentiation of complete versus partial anterior cruciate ligament tears. Arthroscopy. 2013;29:491–9.

    Article  Google Scholar 

  24. Pereira H, Sevivas N, Pereira R, Monteiro A, Oliveira JM, Reis R, et al. New tools for diagnosis, assessment of surgical outcome and follow-up. In: Hermoso JAH, Monllau JC, editors. Lesiones ligamentosas de la rodilla; 2012. p. 185–97.

    Google Scholar 

  25. Tashiro Y, Okazaki K, Miura H, Matsuda S, Yasunaga T, Hashizume M, et al. Quantitative assessment of rotatory instability after anterior cruciate ligament reconstruction. Am J Sports Med. 2009;37:909–16.

    Article  Google Scholar 

  26. Espregueira-Mendes J, Pereira H, Sevivas N, Passos C, Vasconcelos JC, Monteiro A, et al. Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device. Knee Surg Sports Traumatol Arthrosc. 2012;20:671–8.

    Article  Google Scholar 

  27. Espregueira-Mendes J, Andrade R, Leal A, Pereira H, Skaf A, Rodrigues-Gomes S, et al. Global rotation has high sensitivity in ACL lesions within stress MRI. Knee Surg Sports Traumatol Arthrosc. 2017;25:2993–3003.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to João Espregueira-Mendes .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 ISAKOS

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Andrade, R. et al. (2019). An Advanced Device for Multiplanar Instability Assessment in MRI. In: Margheritini, F., Espregueira-Mendes, J., Gobbi, A. (eds) Complex Knee Ligament Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58245-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58245-9_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58244-2

  • Online ISBN: 978-3-662-58245-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics