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Cruciate Ligament Injury (cruciate + ligament_injury)

Distribution by Scientific Domains
Medical Sciences50%

Kinds of Cruciate Ligament Injury

  • anterior cruciate ligament injury
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    Selected Abstracts

    A prospective analysis of incidence and severity of quadriceps inhibition in a consecutive sample of 100 patients with complete acute anterior cruciate ligament rupture

    JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2004
    Terese L. Chmielewski
    Background: Weakness of the quadriceps femoris muscle after anterior cruciate ligament injury and reconstruction has been attributed to incomplete voluntary activation of the muscle. The literature is conflicting on the incidence of incomplete voluntary quadriceps activation after anterior cruciate ligament injury because of differences in testing methods and population biases. The purpose of this study was to systematically examine the incidence and severity of quadriceps voluntary activation failure in both lower extremities after acute anterior cruciate ligament injury. We hypothesized that the incidence of quadriceps inhibition would be higher in the anterior cruciate ligament injured limbs than the uninvolved limbs, that the incidence of inhibition in the anterior cruciate ligament deficient limbs would be larger than in our historical sample of healthy young individuals tested in the same manner and that there would be no difference in inhibition by gender. Study design: Prospective, descriptive. Methods: One hundred consecutive patients with acute anterior cruciate ligament rupture (39 women and 61 men) were tested when range of motion was restored and effusion resolved, an average of 6 weeks after injury. A burst superimposition technique was used to assess quadriceps muscle activation and strength in all patients. Dependent t -tests were used to compare side-to-side differences in quadriceps strength. Independent t -tests were used to compare incidence of activation failure by gender and make comparisons to historical data on young, active individuals. Results: The average involved side quadriceps activation was 0.92, and ranged from 0.60 to 1.00. The incidence of incomplete activation in the involved side quadriceps was 33 per cent and uninvolved side quadriceps was 31 per cent after acute anterior cruciate ligament rupture. The incidence of incomplete activation bilaterally was 21 per cent. There was no difference in incidence of quadriceps inhibition by gender. Conclusion: The incidence of voluntary quadriceps inhibition on the involved side was three times that of uninjured, active young subjects, but the magnitude was not large. The incidence of quadriceps inhibition on the uninjured side was similar to the injured side. Clinical relevance: Both the incidence and magnitude of quadriceps inhibition after ACL rupture are lower than have previously been reported. The conventional wisdom, therefore, that quadriceps inhibition is a significant problem in this population is challenged by the results of this study. Differences between this study and others include sufficient practice to ensure a maximal effort contraction and rigorous inclusion criteria. The findings have implications for strength testing as well as rehabilitation. The quadriceps index, an assessment of the injured side quadriceps strength deficit may be affected by the presence of voluntary activation failure in the uninvolved side. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source]

    Specificity of muscle action after anterior cruciate ligament injury

    JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2003
    Glenn N. Williams
    Abstract Neuromuscular control is believed to be a critical factor in dynamic knee stability. The purpose of this study was to evaluate voluntary muscle control in anterior cruciate ligament deficient (ACL-D) and uninjured people. Twenty athletes of similar age participated in this study. Subjects performed a target-matching protocol that required them to produce isometric moments about the knee with fine control in flexion, extension, varus, and valgus (i.e., loads were generated in the plane perpendicular to the long axis of the shank). Electromyographic data were collected from 10 muscles that span the knee. A specificity index was calculated for each muscle to describe how fine-tuned (specific) its muscle activity pattern was with respect to its principal direction of action in the load plane. Diminished specificity of muscle action was observed in 8 of 10 muscles in the ACL-D subjects' involved knees when compared with the activity patterns from their uninvolved knees and those from the uninjured subjects' knees. The vastus lateralis muscle was especially affected. Increased and more global co-contraction was also observed in the ACL-D limbs. The alterations in muscle firing patterns observed in this study are consistent with diminished neuromuscular control. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

    Knee pain in the ACL-deficient osteoarthritic knee and its relationship to quality of life

    PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2003
    Michael Hartwick
    Abstract Background and Purpose Pain during activities of daily living is a common presenting complaint of individuals with knee osteoarthritis and anterior cruciate ligament injury. Knee pain is also associated with a decrease in quality of life for people with osteoarthritis. The purpose of the present study was to examine the dose,response relationship between knee joint forces and painful symptoms, and whether the acute symptoms, were associated with individuals' quality of life. Method This was a cross-sectional cohort correlation study. Seventeen individuals with anterior cruciate ligament (ACL)-deficient knees diagnosed with ipsilateral knee osteoarthritis completed the ACL quality of life questionnaire (ACL-QOL). The subjects also rated pain associated with each of five incremental isometric knee extension tests, proportional to their body weight. Analysis of variance was used to assess the association between pain and normalized torque. Linear regression was used to assess the correlation between the ACL-QOL score and the total pain experienced during the graded test. Results A strong relationship was found between the level of perceived knee pain and the amount of isometric torque produced (Pearson's r = 0.98; p<0.001). There was a statistically significant relationship between pain during the graded isometric test and the ACL-QOL (Pearson's r = ,0.56; p = 0.016). Conclusions Since knee joint compression is a function of active isometric knee extension torque, increased painful symptoms were associated with increased compression forces at the knee joint for these subjects. The relationship between pain provocation and disease-specific quality of life provides evidence for the proposed joint provocation test for this subject population. Weakness caused by osteoarthritis (OA) may, in part, be a negative conditioning response that would need to be overcome in rehabilitation. Copyright © 2003 Whurr Publishers Ltd. [source]

    The impact of anterior cruciate ligament injury on lubricin metabolism and the effect of inhibiting tumor necrosis factor , on chondroprotection in an animal model

    ARTHRITIS & RHEUMATISM, Issue 10 2009
    K. A. Elsaid
    Objective To examine the effects of anterior cruciate ligament transection (ACLT) in a rat model on lubricin metabolism and its relationship to markers of inflammation and cartilage damage, and to determine whether blocking the metabolic effects of tumor necrosis factor , (TNF,) by etanercept increases the chondroprotection provided by lubricin. Methods Unilateral ACLT was performed in Lewis rats. Levels of lubricin, TNF,, interleukin-1, (IL-1,), and sulfated glycosaminoglycans (sGAG) in synovial fluid (SF) lavage specimens and synovial tissue lubricin gene expression were evaluated at 1 week and 4 weeks following ACLT. Histologic evaluation of articular cartilage included staining with lubricin-specific monoclonal antibody 9G3 and Safranin O. The percentage of lubricin staining on the surface of articular cartilage in weight-bearing areas was estimated by digital imaging. Blocking of TNF, was performed using etanercept, which was administered subcutaneously at a dose of 0.5 mg/kg around the ACL-transected joints, using different dosing strategies. The ACL-transected and contralateral joints of these rats were harvested 4 weeks following surgery. Results Four weeks following ACLT, SF lubricin concentrations and the percentage of cartilage surface lubricin staining were significantly lower in the injured joints compared with the contralateral joints. A significant decrease in synovial tissue lubricin gene expression was associated with elevated TNF, and IL-1, concentrations in SF lavage samples. With all of the etanercept treatment strategies, blocking of TNF, significantly increased the amount of lubricin bound to cartilage, coupled with a significant decrease in sGAG release. However, changes in the concentrations of lubricin in SF were variable. Conclusion Blocking TNF, resulted in a chondroprotective effect, exemplified by increased lubricin deposition on articular cartilage and a decrease in sGAG release from articular cartilage in an animal model of posttraumatic arthritis. [source]