1. Assessment of knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT): a novel protocol and preliminary results.
- Author
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Leão RV, Zelada SRB, Lobo CFT, da Silva AGM, Godoy-Santos AL, Gobbi RG, Helito PVP, and Helito CP
- Subjects
- Humans, Male, Adult, Knee Injuries diagnostic imaging, Young Adult, Knee Joint diagnostic imaging, Weight-Bearing, Joint Instability diagnostic imaging, Anterior Cruciate Ligament Injuries diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Objective: To propose a protocol for assessing knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT)., Materials and Methods: We enrolled five patients with unilateral chronic ACL tears referred for WBCT. Bilateral images were obtained in four positions: bilateral knee extension, bilateral knee flexion, single-leg stance with knee flexion and external rotation, and single-leg stance with knee flexion and internal rotation. The radiation dose, time for protocol acquisition, and patients' tolerance of the procedure were recorded. A blinded senior radiologist assessed image quality and measured the anterior tibial translation (ATT) and femorotibial rotation (FTR) angle in the ACL-deficient and contralateral healthy knee., Results: All five patients were male, aged 23-30 years old. The protocol resulted in a 16.2 mGy radiation dose and a 15-min acquisition time. The procedure was well-tolerated, and patient positioning was uneventful, providing good-quality images. In all positions, the mean ATT and FTR were greater in ACL-deficient knees versus the healthy knee, with more pronounced differences observed in the bilateral knee flexion position. Mean lateral ATT in the flexion position was 9.1±2.8 cm in the ACL-injured knees versus 4.0±1.8 cm in non-injured knees, and mean FTR angle in the bilateral flexion position was 13.5°±7.7 and 8.6°±4.6 in the injured and non-injured knees, respectively., Conclusion: Our protocol quantitatively assesses knee instability with WBCT, measuring ATT and FTR in diverse knee positions. It employs reasonable radiation, is fast, well-tolerated, and yields high-quality images. Preliminary findings suggest ACL-deficient knees show elevated ATT and FTR, particularly in the 30° flexion position., (© 2024. The Author(s), under exclusive licence to International Skeletal Society (ISS).)
- Published
- 2024
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