Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge

Abstract

Background:Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information.Objectives:In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients.Patients and Methods:For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur.Results:Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant.Conclusion:Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.

Electromyographic analysis of anterior cruciate deficient knees with and without functional bracing during lunge exercise

“…The results from a two-dimensional (2D) digital fluoroscopy study showed no differences in anterior tibial translation during lunge exercise when wearing FKBs. 32 Lower gastrocnemius involvement perhaps may lead to reduced medial compartment contact pressure and may help lower the risk of osteoarthritis, with high loads detrimental to joint integrity for those with ACL deficiency. With its origin on the medial femoral condyle, perhaps reduced medial gastrocnemius activity may better guide knee rotation and assist the joint achieve healthier kinematic pattern.…”

Band pass filter plan in fluoroscopy for high energy range

“…Thus, in order to obtain the best possible X-ray band pass spectrum, the analysis of attenuation and absorption profiles of different elements has an essential position in computing the output intensities using selection of the finest as a filter. At present, X-ray low-band filters are widely used in medical centers [8][9][10][11]. With these filters, the passage of high-energy photons could be prevented without affecting or impairing the image quality [12][13][14][15][16].…”

Do Prophylactic Knee Braces Protect the Knee Against Impacts or Tibial Moments? An In Vitro Multisensory Study

“…6 Another in vivo study used video fluoroscopy to investigate the effect of bracing and found no difference between the braced and unbraced conditions in tibial translation. 21 Bing et al 7 found a decreased knee flexion angle in the braced knee for a stop-jump task and concluded that knee braces might prevent ACL injuries.…”