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Diffusion tensor imaging in assessment of the knee stability after ACL reconstructionObjective Study of the value of diffusion tensor imaging in assessment of the knee stability in early ACL reconstruction.Materials and methods 40 cases of anterior cruciate ligament reconstruction surgery patients in 6-12 months after surgery.All patients who were divided into stable group(34 cases)and unstable group(6 cases)by the results of physical examination,were performed conventional MRI and diffusion tensor imaging.The MR positive rate of the graft was judged by the signal and morphology,while the graft FA were measured by diffusion tensor imaging.Diffusion tensor tractography was used to judge the continuity of ACL graft.The positive rate difference of 2 groups on graft MRI and diffusion tensor tractography was used chi square test.Two groups of values of FA was used t test.Kappa consistency test was used to test the consistency of graft MRI and diffusion tensor tractography(DTT)with clinical examination results.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of two kinds of methods in diagnosis of knee joint stability was tested.Results There was no significant difference of graft FA value between unstable group and the stable group,and the difference of positive rate of graft MR expression between two groups was not statistically significant The difference of the positive rate of DTT in the two groups was statistically significant,and the instability group was higher than the stable group.(P<0.001).The consistency of DTT and clinical examination results of Kappa was 0.608,P<0.001.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DTT diagnosis of graft fracture were 66.67%,94.12%,90%,66.67% and 94.12%.Conclusion DTT has a certain value in evaluating the stability of the knee joint in the early stage of anterior cruciate ligament reconstruction,which can provide valuable information for clinical follow-up and two operations.The FA value of diffusion tensor imaging can not be used to evaluate the stability of the knee joint after the reconstruction of anterior cruciate ligamentPART ? Based on the kinematics of the knee anterior cruciate ligament reconstruction weight-bearing after MRIObjective The application value of weight-bearing magnetic resonance imaging to evaluate the stability of knee joint after anterior cruciate ligament injury or reconstruction.Materials and methods 25 cases of patients with anterior cruciate ligament rupture and reconstruction surgery.All patients were performed weight-bearing magnetic resonance,knee joint passive relaxation test(Kneelax 3)and Lysholm score at the preoperative,3 months and 6 months after operation.The preoperative and postoperative outcomes of the three groups were analyzed by randomized block ANOVA.The correlation between the three preoperative examinations was statistically analyzed.P < 0.05 was statistically significant.Result The relaxation data measured by Kneelax 3 after operation(1.1 + 0.9)was significantly lower than that before operation(6.1 + 1.3).The tibial anterior shift(3 + 0.7)after operation was less than that before operation(4.8 + 1.2).The score of Lysholm score was(88.8 + 6.3)after operation(8.8 + 6.3),which was significantly higher than that before operation(64.4 + 13.7).The differences of the 3 methods were statistically significant.There was a negative correlation between the forward shift of the lateral platform and the Lysholm score(P<0.01).And there was no correlation between the front shift of the lateral platform and the passive relaxation test.Kneelax 3 the measured relaxation data after operation(1.1 ± 0.9)was significantly less than that before operation(6.1 ± 1.3).Weight-bearing MRI of tibial antedisplacement postoperative(3 ± 0.7)less than the preoperative(4.8 ± 1.2).Lysholm score in postoperative score of 8(8.8 ± 6.3)was significantly higher than that before operation(64.4 ± 13.7).The 3 methods were statistically significant.There is a negative correlation between the preoperative magnetic resonance lateral weight-bearing platform forward degree and Lysholm score(P<0.01).No correlation between preoperative weight-bearing MRI lateral platform forward and passive relaxation test.Conclusion Anterior cruciate ligament reconstruction surgery can improve the stability of the knee joint.The tibial anterior displacement measured by weight-bearing magnetic resonance is correlated with the clinical score.We can consider the method of weight-bearing magnetic resonance to evaluate the stability of the knee joint.Part ? The role of hamstring muscle in stability of ACL deficit knee,a study based on weight-bearing MRIObjective Through the weight-bearing MRI examination,to explore the effect of enhanced hamstring strength on the stability of the knee.Materials and methods 30 patients with anterior cruciate ligament tears diagnosed by clinical and magnetic resonance imaging were randomly divided into group A and group B.Standard rehabilitation training of two groups were performed,A group increased hamstring muscle training,while B group not.All patients performed passive relaxation(Kneelax 3),Lysholm score and the magnetic resonance imaging(MRI)after rehabilitation training.The weight-bearing MR was used to measure the tibial forward shift.The paired t test was used before and after the rehabilitation training.An independent sample t test was used between the 2 groups of patients.The data of the Kneelax3 and tibial shift data subtracted is the ratio of dynamic factors to the stability of the knee joint.The A group and the B group were compared with the independent sample t test.All statistical methods were statistically significant in P < 0.05Results The difference between the 2 groups of patients with Kneelax 3 was not statistically significant before the rehabilitation training(4.9 + 1.6,4.7 + 1.3)and after rehabilitation(4.8 + 1.6,4.9 + 1.2).The Lysholm score increased significantly before rehabilitation(78.9 + 5.3,79.1 + 4.6)and after rehabilitation(82.3 + 7.5,85.9 + 6.9),the difference was statistically significant.It was found that the tibial shift of A group was significantly decreased after rehabilitation(2.5 + 1.2,1.5 + 1),and the difference was statistically significant.The tibial forward shift of group B was not statistically significant after rehabilitation(3.4 + 0.9,3.5 + 1.2).The results of Kneelax 3 and Lysholm scores were measured by independent sample t test among groups of A and B after rehabilitation,and the difference was not statistically significant.There was significant difference of weight-bearing MR between the A and B groups after rehabilitation.The ratio of the dynamic factors in the group A was higher than that in the B group,and the difference was statistically significant.Conclusion Strengthening hamstring muscle can reduce the tibial shift on weight-bearing condition,though which has no significant effect on the results of passive relaxation and Lysholm scores.Strengthening the hamstring muscle can increase the stability of the knee joint... |
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