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A dynamic study of the anterior cruciate ligament of the knee using an open MRI

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Abstract

Recent anatomical and radiological studies of the anterior cruciate ligament (ACL) suggest the ACL length and orientation change during knee flexion, and an open MRI sequencing during knee flexion enables a dynamic ACL analysis. This study’s goal is to describe a normal ACL using a 1T open MRI and, in particular, variations in length and insertion angles at different degrees of flexion. Twenty-one volunteers with clinically healthy knees received a dynamic MRI with their knees in hyperextension, neutral position, and flexed at 45° and 90° angles. For each position, two radiologists measured the ACL lengths and angles of the proximal insertion between the ACL’s anterior edge and the roof of the inter-condylar notch. Additionally, we measured the ACL’s and the tibial plateau’s distal angle insertion between their anterior edges and then compared these with the nonparametric Wilcoxon test. The ACL had a significant extension between the 90° flexion and all other positions (hyperextension: 31.75 ± 2.5 mm, neutral position: 32.5 ± 2.6 mm, 45°: 35.6 ± 1.6 mm, 90°: 35.6 ± 1.6 mm). There was also a significant increase of the angle insertion between the proximal 90° flexion and all other positions, as well as between hyperextension and bending to 45° (hyperextension: 2.45° ± 3.7°, neutral: 13.4° ± 9.7°, 45°: 33 25 ± 9.3, 90: 51.85° ± 9.3°). Additionally, there is a significant increase in the distal angle insertion for all positions (hyperextension: 133.2° ± 5.4°, neutral position: 134.95° ± 4.4°, 45°: 138.35° ± 5.9°, 90°: 149.15° ± 8.6°). Our study is the first to exhibit that a dynamic MRI has a significant ACL extension in vivo during bending. This concept opens the way for further studies to improve the diagnosis of traumatic ACL injuries using a dynamic MRI.

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Authors and Affiliations

  1. Department of Radiology, Sainte-Marguerite Hospital, Institute for Locomotion, APHM, 13009, Marseille, France

    Daphne Guenoun, Julien Vaccaro, Thomas Le Corroller, Pierre-Antoine Barral, Benjamin Coquart & Pierre Champsaur

  2. Department of Anatomy, Aix Marseille Université, 13005, Marseille, France

    Aude Lagier

  3. Unité de Recherche EA3279, Santé Publique et Maladies Chroniques: Qualité de vie Concepts, Usages et Limites, Déterminants, Aix Marseille Université, 13005, Marseille, France

    Vanessa Pauly

  4. Department of Rheumatology, Sainte-Marguerite Hospital, Institute for Locomotion, APHM, 13009, Marseille, France

    Joel Coste

Authors
  1. Daphne Guenoun
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  2. Julien Vaccaro
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  3. Thomas Le Corroller
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  4. Pierre-Antoine Barral
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  5. Aude Lagier
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  6. Vanessa Pauly
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  7. Benjamin Coquart
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  8. Joel Coste
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  9. Pierre Champsaur
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Correspondence to Daphne Guenoun.

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Guenoun, D., Vaccaro, J., Le Corroller, T. et al. A dynamic study of the anterior cruciate ligament of the knee using an open MRI. Surg Radiol Anat 39, 307–314 (2017). https://doi.org/10.1007/s00276-016-1730-x

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  • DOI: https://doi.org/10.1007/s00276-016-1730-x

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