Abstract
Knee laxity, by definition, is a dynamic and multifactorial condition. MRI evaluation, due to its known capacity in achieving high soft tissue contrast (e.g., meniscus, synovia, ligaments, cartilage) and multiplanar joint assessment without ionizing radiation, has contributed to its popularity in the last decades. However, “traditional” MRI studies provide static evaluation, thus requiring careful correlation to clinical findings, particularly when dealing with functional ligament stability. This work aims to describe the most important features of current MRI studies when dealing with anterior cruciate ligaments injuries, while also presenting the evolving possibilities of dynamic and objective MRI assessment of knee instability.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Araujo PH, Kfuri Junior M, Ohashi B, Hoshino Y, Zaffagnini S, Samuelsson K, Karlsson J, Fu F, Musahl V (2014) Individualized ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 22(9):1966–1975. doi:10.1007/s00167-014-2928-2
Arilla FV, Yeung M, Bell K, Rahnemai-Azar AA, Rothrauff BB, Fu FH, Debski RE, Ayeni OR, Musahl V (2015) Experimental execution of the simulated Pivot-Shift Test: a systematic review of techniques. Arthrosc 31:2445–2454. doi:10.1016/j.arthro.2015.06.027
Behairy NH, Dorgham MA, Khaled SA (2009) Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy. Int Orthop 33(4):961–967. doi:10.1007/s00264-008-0580-5
Benjaminse A, Gokeler A, van der Schans CP (2006) Clinical diagnosis of an anterior cruciate ligament rupture: a meta-analysis. J Orthop Sports Phys Ther 36(5):267–288. doi:10.2519/jospt.2006.2011
Bjornsson H, Desai N, Musahl V, Alentorn-Geli E, Bhandari M, Fu F, Samuelsson K (2015) Is double-bundle anterior cruciate ligament reconstruction superior to single-bundle? a comprehensive systematic review. Knee Surg Sports Traumatol Arthrosc 23(3):696–739. doi:10.1007/s00167-013-2666-x
Brandon ML, Haynes PT, Bonamo JR, Flynn MI, Barrett GR, Sherman MF (2006) The association between posterior-inferior tibial slope and anterior cruciate ligament insufficiency. Arthrosc 22(8):894–899. doi:10.1016/j.arthro.2006.04.098
Brandser EA, Riley MA, Berbaum KS, el-Khoury GY, Bennett DL (1996) MR imaging of anterior cruciate ligament injury: independent value of primary and secondary signs. AJR Am J Roentgenol 167((1):121–126. doi:10.2214/ajr.167.1.8659355
Campos JC, Chung CB, Lektrakul N, Pedowitz R, Trudell D, Yu J, Resnick D (2001) Pathogenesis of the segond fracture: anatomic and MR imaging evidence of an iliotibial tract or anterior oblique band avulsion. Radiology 219(2):381–386. doi:10.1148/radiology.219.2.r01ma23381
Chan WP, Peterfy C, Fritz RC, Genant HK (1994) MR diagnosis of complete tears of the anterior cruciate ligament of the knee: importance of anterior subluxation of the tibia. AJR Am J Roentgenol 162(2):355–360. doi:10.2214/ajr.162.2.8310927
Citak M, Suero EM, Rozell JC, Bosscher MR, Kuestermeyer J, Pearle AD (2011) A mechanized and standardized pivot shifter: technical description and first evaluation. Knee Surg Sports Traumatol Arthrosc 19(5):707–711. doi:10.1007/s00167-010-1289-8
DeFranco MJ, Bach BR Jr (2009) A comprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am 91(1):198–208. doi:10.2106/JBJS.H.00819
Espregueira-Mendes J, Pereira H, Sevivas N, Passos C, Vasconcelos JC, Monteiro A, Oliveira JM, Reis RL (2012) Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device. Knee Surg Sports Traumatol Arthrosc 20(4):671–678. doi:10.1007/s00167-012-1914-9
Falchook FS, Tigges S, Carpenter WA, Branch TP, Stiles RG (1996) Accuracy of direct signs of tears of the anterior cruciate ligament. Can Assoc Radiol J (Journal l’Association canadienne des radiologistes) 47(2):114–120
Fitzgerald SW, Remer EM, Friedman H, Rogers LF, Hendrix RW, Schafer MF (1993) MR evaluation of the anterior cruciate ligament: value of supplementing sagittal images with coronal and axial images. AJR Am J Roentgenol 160(6):1233–1237. doi:10.2214/ajr.160.6.8498224
Fruensgaard S, Johannsen HV (1989) Incomplete ruptures of the anterior cruciate ligament. J Bone Joint Surg 71(3):526–530
Giaconi JC, Allen CR, Steinbach LS (2009) Anterior cruciate ligament graft reconstruction: clinical, technical, and imaging overview. Top Magn Reson Imaging : TMRI 20(3):129–150. doi:10.1097/RMR.0b013e3181d657a7
Grzelak P, Podgorski MT, Stefanczyk L, Domzalski M (2015) Ultrasonographic test for complete anterior cruciate ligament injury. Indian J Orthop 49(2):143–149. doi:10.4103/0019-5413.152432
Hoshino Y, Kuroda R, Nagamune K, Araki D, Kubo S, Yamaguchi M, Kurosaka M (2012) Optimal measurement of clinical rotational test for evaluating anterior cruciate ligament insufficiency. Knee Surg Sports Traumatol Arthrosc 20(7):1323–1330. doi:10.1007/s00167-011-1643-5
Hoshino Y, Musahl V, Irrgang JJ, Lopomo N, Zaffagnini S, Karlsson J, Kuroda R, Fu FH (2015) Quantitative evaluation of the Pivot Shift - relationship to clinical Pivot Shift Grade: a prospective international multicenter study. Orthop J Sports Med 3(2 suppl):56–72. doi:10.1177/2325967115s00108
Isberg J, Faxen E, Brandsson S, Eriksson BI, Karrholm J, Karlsson J (2006) KT-1000 records smaller side-to-side differences than radiostereometric analysis before and after an ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14(6):529–535. doi:10.1007/s00167-006-0061-6
Jonsson H, Riklund-Ahlstrom K, Lind J (2004) Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5–9 years after surgery. Acta Orthop Scand 75(5):594–599. doi:10.1080/00016470410001484
Juhng SK, Lee JK, Choi SS, Yoon KH, Roh BS, Won JJ (2002) MR evaluation of the “arcuate” sign of posterolateral knee instability. AJR Am J Roentgenol 178(3):583–588. doi:10.2214/ajr.178.3.1780583
Kato Y, Maeyama A, Lertwanich P, Wang JH, Ingham SJ, Kramer S, Martins CQ, Smolinski P, Fu FH (2013) Biomechanical comparison of different graft positions for single-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 21(4):816–823. doi:10.1007/s00167-012-1951-4
Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32(3):629–634
Kothari A, Haughom B, Subburaj K, Feeley B, Li X, Ma CB (2012) Evaluating rotational kinematics of the knee in ACL reconstructed patients using 3.0 Tesla magnetic resonance imaging. Knee 19(5):648–651. doi:10.1016/j.knee.2011.12.001
Kuroda R, Hoshino Y, Kubo S, Araki D, Oka S, Nagamune K, Kurosaka M (2011) Similarities and Differences of Diagnostic Manual Tests for Anterior Cruciate Ligament Insufficiency: A Global Survey and Kinematics Assessment. Am J Sports Med. doi:10.1177/0363546511423634, 0363546511423634 [pii]
Lane CG, Warren R, Pearle AD (2008) The pivot shift. J Am Acad Orthop Surg 16(12):679–688, doi: 16/12/679 [pii]
Lawrance JA, Ostlere SJ, Dodd CA (1996) MRI diagnosis of partial tears of the anterior cruciate ligament. Injury 27(3):153–155
Lee K, Siegel MJ, Lau DM, Hildebolt CF, Matava MJ (1999) Anterior cruciate ligament tears: MR imaging-based diagnosis in a pediatric population. Radiology 213(3):697–704. doi:10.1148/radiology.213.3.r99dc26697
Lee SY, Matsui N, Yoshida K, Doi R, Matsushima S, Wakami T, Fujii M, Yoshiya S, Kurosaka M, Yamamoto T (2005) Magnetic resonance delineation of the anterior cruciate ligament of the knee: flexed knee position within a surface coil. Clin Imaging 29(2):117–122. doi:10.1016/j.clinimag.2004.04.024
Leitze Z, Losee RE, Jokl P, Johnson TR, Feagin JA (2005) Implications of the pivot shift in the ACL-deficient knee. Clin Orthop Relat Res 436:229–236
Mellado JM, Calmet J, Olona M, Gine J, Sauri A (2004) Magnetic resonance imaging of anterior cruciate ligament tears: reevaluation of quantitative parameters and imaging findings including a simplified method for measuring the anterior cruciate ligament angle. Knee Surg Sports Traumatol Arthrosc 12(3):217–224. doi:10.1007/s00167-003-0431-2
Mink JH, Levy T, Crues JV 3rd (1988) Tears of the anterior cruciate ligament and menisci of the knee: MR imaging evaluation. Radiology 167(3):769–774. doi:10.1148/radiology.167.3.3363138
Muller B, Hofbauer M, Rahnemai-Azar AA, Wolf M, Araki D, Hoshino Y, Araujo P, Debski RE, Irrgang JJ, Fu FH, Musahl V (2015) Development of computer tablet software for clinical quantification of lateral knee compartment translation during the pivot shift test. Comput Methods Biomech Biomed Engin 19:1–12. doi:10.1080/10255842.2015.1006210
Murphy BJ, Smith RL, Uribe JW, Janecki CJ, Hechtman KS, Mangasarian RA (1992) Bone signal abnormalities in the posterolateral tibia and lateral femoral condyle in complete tears of the anterior cruciate ligament: a specific sign? Radiology 182(1):221–224. doi:10.1148/radiology.182.1.1727286
Musahl V, Voos J, O’Loughlin PF, Stueber V, Kendoff D, Pearle AD (2010) Mechanized pivot shift test achieves greater accuracy than manual pivot shift test. Knee Surg Sports Traumatol Arthrosc 18(9):1208–1213. doi:10.1007/s00167-009-1004-9
Noyes FR, Mooar LA, Moorman CT 3rd, McGinniss GH (1989) Partial tears of the anterior cruciate ligament. progression to complete ligament deficiency. J Bone Joint Surg 71(5):825–833
Ochi M, Adachi N, Deie M, Kanaya A (2006) Anterior cruciate ligament augmentation procedure with a 1-incision technique: anteromedial bundle or posterolateral bundle reconstruction. Arthroscopy 22(4):463 e461–465. doi:10.1016/j.arthro.2005.06.034, S0749-8063(05)01560-4 [pii]
Ohashi B, Ward J, Araujo P, Kfuri M, Pereira H, Espregueira-Mendes J, Musahl V (2014) Partial ACL Ruptures: knee laxity measurements and Pivot Shift. In: Doral MN, Karlsson J (eds) Sports injuries. Springer, Berlin/Heidelberg, pp 1–16. doi:10.1007/978-3-642-36801-1_85-1
Pereira H, Fernandes M, Pereira R, Jones H, Vasconcelos JC, Oliveira JM, Reis RL, Musahl V, Espregueira-Mendes J (2014) ACL injuries identifiable for Pre-participation imagiological analysis: risk factors. In: Doral MN, Karlsson J (eds) Sports injuries. Springer, Berlin/Heidelberg, pp 1–15. doi:10.1007/978-3-642-36801-1_80-1
Pereira H, Sevivas N, Pereira R, Monteiro A, Oliveira JM, Reis RL, Espregueira-Mendes J (2012) New tools for diagnosis, assessment of surgical outcome and follow-up. In: Hernández JA, Monllau JC (eds) Lesiones ligamentosas de la rodilla. Marge Médica Books Barcelona, Spain, pp 185–198
Pereira H, Sevivas N, Pereira R, Monteiro A, Sampaio R, Oliveira J, Reis R, Espregueira-Mendes J (2014) Systematic approach from Porto School. In: Siebold R, Dejour D, Zaffagnini S (eds) Anterior cruciate ligament reconstruction. Springer, Berlin/Heidelberg, pp 367–386. doi:10.1007/978-3-642-45349-6_34
Prince JS, Laor T, Bean JA (2005) MRI of anterior cruciate ligament injuries and associated findings in the pediatric knee: changes with skeletal maturation. AJR Am J Roentgenol 185(3):756–762. doi:10.2214/ajr.185.3.01850756
Prins M (2006) The Lachman test is the most sensitive and the pivot shift the most specific test for the diagnosis of ACL rupture. Aust J Physiother 52(1):66. doi:http://dx.doi.org/10.1016/S0004-9514(06)70069-1
Remer EM, Fitzgerald SW, Friedman H, Rogers LF, Hendrix RW, Schafer MF (1992) Anterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiogr Rev Publ Radiol Soc N Am, Inc 12(5):901–915. doi:10.1148/radiographics.12.5.1529133
Resnick D (1995) Diagnosis of bone and joint disorders. 3rd edn. WB Saunders Co, Philadelphia
Robertson PL, Schweitzer ME, Bartolozzi AR, Ugoni A (1994) Anterior cruciate ligament tears: evaluation of multiple signs with MR imaging. Radiology 193(3):829–834. doi:10.1148/radiology.193.3.7972833
Roychowdhury S, Fitzgerald SW, Sonin AH, Peduto AJ, Miller FH, Hoff FL (1997) Using MR imaging to diagnose partial tears of the anterior cruciate ligament: value of axial images. AJR Am J Roentgenol 168(6):1487–1491. doi:10.2214/ajr.168.6.9168712
Rubin DA, Kettering JM, Towers JD, Britton CA (1998) MR imaging of knees having isolated and combined ligament injuries. AJR Am J Roentgenol 170(5):1207–1213. doi:10.2214/ajr.170.5.9574586
Sonnery-Cottet B, Lavoie F, Ogassawara R, Scussiato RG, Kidder JF, Chambat P (2010) Selective anteromedial bundle reconstruction in partial ACL tears: a series of 36 patients with mean 24 months follow-up. Knee Surg Sports Traumatol Arthrosc 18(1):47–51. doi:10.1007/s00167-009-0855-4
Staubli HU, Noesberger B, Jakob RP (1992) Stress radiography of the knee. Cruciate ligament function studied in 138 patients. Acta Orthop Scand Suppl 249:1–27
Stoller D (1997) Magnetic resonance imaging in orthopaedics and sports medicine. 2nd edn. Lippincott-Raven, Philadelphia
Swain MS, Henschke N, Kamper SJ, Downie AS, Koes BW, Maher CG (2014) Accuracy of clinical tests in the diagnosis of anterior cruciate ligament injury: a systematic review. Chiropr Man Therap 22:25. doi:10.1186/s12998-014-0025-8
Terzidis IP, Christodoulou AG, Ploumis AL, Metsovitis SR, Koimtzis M, Givissis P (2004) The appearance of kissing contusion in the acutely injured knee in the athletes. Br J Sports Med 38(5):592–596. doi:10.1136/bjsm.2003.006718
Toye LR, Cummings DP, Armendariz G (2002) Adult tibial intercondylar eminence fracture: evaluation with MR imaging. Skeletal Radiol 31(1):46–48. doi:10.1007/s00256-001-0440-5
Tung GA, Davis LM, Wiggins ME, Fadale PD (1993) Tears of the anterior cruciate ligament: primary and secondary signs at MR imaging. Radiology 188(3):661–667. doi:10.1148/radiology.188.3.8351329
Vahey TN, Broome DR, Kayes KJ, Shelbourne KD (1991) Acute and chronic tears of the anterior cruciate ligament: differential features at MR imaging. Radiology 181(1):251–253. doi:10.1148/radiology.181.1.1887042
Van Dyck P, De Smet E, Veryser J, Lambrecht V, Gielen JL, Vanhoenacker FM, Dossche L, Parizel PM (2012) Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging. Knee Surg Sports Traumatol Arthrosc 20(2):256–261. doi:10.1007/s00167-011-1617-7
Van Dyck P, Vanhoenacker FM, Gielen JL, Dossche L, Van Gestel J, Wouters K, Parizel PM (2011) Three tesla magnetic resonance imaging of the anterior cruciate ligament of the knee: can we differentiate complete from partial tears? Skeletal Radiol 40(6):701–707. doi:10.1007/s00256-010-1044-8
Van Dyck P, Vanhoenacker FM, Lambrecht V, Wouters K, Gielen JL, Dossche L, Parizel PM (2013) Prospective comparison of 1.5 and 3.0-T MRI for evaluating the knee menisci and ACL. J Bone Joint Surg Am 95(10):916–924. doi:10.2106/JBJS.L.01195
Winters K, Tregonning R (2005) Reliability of magnetic resonance imaging of the traumatic knee as determined by arthroscopy. N Z Med J 118(1209):U1301
Yasuda K, van Eck CF, Hoshino Y, Fu FH, Tashman S (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction, part 1: basic science. Am J Sports Med 39(8):1789–1799. doi:10.1177/0363546511402659
Yu JS, Goodwin D, Salonen D, Pathria MN, Resnick D, Dardani M, Schweitzer M (1995) Complete dislocation of the knee: spectrum of associated soft-tissue injuries depicted by MR imaging. AJR Am J Roentgenol 164(1):135–139. doi:10.2214/ajr.164.1.7998526
Zaffagnini S, Bignozzi S, Martelli S, Imakiire N, Lopomo N, Marcacci M (2006) New intraoperative protocol for kinematic evaluation of ACL reconstruction: preliminary results. Knee Surg Sports Traumatol Arthrosc 14(9):811–816. doi:10.1007/s00167-006-0057-2
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Pereira, H. et al. (2017). MRI Laxity Assessment. In: Musahl, V., Karlsson, J., Kuroda, R., Zaffagnini, S. (eds) Rotatory Knee Instability. Springer, Cham. https://doi.org/10.1007/978-3-319-32070-0_5
Download citation
DOI: https://doi.org/10.1007/978-3-319-32070-0_5
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-32069-4
Online ISBN: 978-3-319-32070-0
eBook Packages: MedicineMedicine (R0)