UVM Theses and Dissertations
Format:
Print
Author:
Sturnick, Daniel
Dept./Program:
Mechanical Engineering
Year:
2013
Degree:
MS
Abstract:
Injuries to the Anterior Cruciate Ligament (ACL), an important stabilizing ligament of the knee, are prevalent among young activeindividuals and lead to the early onset of post-traumatic osteoarthritis (PTOA). Research has focused on developing a comprehensive understanding of the risk factors associated with an ACL injury, to identify individuals at increased risk for injury and design of injury prevention programs. Risk of suffering an ACL injury is multifactorial and different for males and females. The morphological measure of the distal femur intercondylar notch size, the posterior directed slope of the subchondral bone surface of the tibial plateau, the depth of concavity of the medial tibial plateau subchondral bone surface, the posterior directed slope of meniscal horns and the size ACL itself have been associated with the risk of suffering an ACL injury. Sufficient measurements of the tibial plateau articular cartilage surface and meniscus, where tibiofemoral contact occurs, or the tibial spines have not been developed and investigated in association with ACL injury risk. Theoretically, these factors have biomechanical implications that may influence the strain behavior of the ACL and consequentially relate to the probability of rupturing the ligament.
The objective of this investigation was to develop a multivariate risk model using the MRI-based measurements of knee morphology in an effort to determine which factors are most independently predictive of risk of suffering an ACL injury. The goals of this study were 3-part: 1) Measurements of tibial plateau articular cartilage and meniscus morphology were developed and investigated in association with risk. Analyses of risk were made considering males and females as combined and separate groups. 2) Measurements of tibial spine morphology were developed and investigated in association with risk, again with males and females analyzed as combined and separate groups. 3) Comprehensive best-fit multivariate risk models of anatomical measurements, both novel and previously described in the literature, were developed for males and females as combined and separate groups.
In part 1 of this investigation, the morphology of the articular cartilage surface and posterior meniscus of the lateral compartment were associated with the risk of suffering an ACL injury in females. In part 2, the size of the medial compartment tibial spine was significantly associated with the risk of suffering an ACL injury in males. In part 3, the comprehensive best-fit anatomical risk model included measurements of articular cartilage of the laternal tibial plateau and the of the femoral intercondylar notch morphology for females, and measurements of lateral posterior meniscus and ACL morphology for males.
The comprehensive models for anatomical risk factors of knee morphology were different between males and females. Sex specific screening tools may be developed to identify individuals at an increased risk of suffering an ACL injury. Measurements of articular cartilage and meniscus morphology proved to be more independently associated with risk in contrast to measurements previously described in the literature.
The objective of this investigation was to develop a multivariate risk model using the MRI-based measurements of knee morphology in an effort to determine which factors are most independently predictive of risk of suffering an ACL injury. The goals of this study were 3-part: 1) Measurements of tibial plateau articular cartilage and meniscus morphology were developed and investigated in association with risk. Analyses of risk were made considering males and females as combined and separate groups. 2) Measurements of tibial spine morphology were developed and investigated in association with risk, again with males and females analyzed as combined and separate groups. 3) Comprehensive best-fit multivariate risk models of anatomical measurements, both novel and previously described in the literature, were developed for males and females as combined and separate groups.
In part 1 of this investigation, the morphology of the articular cartilage surface and posterior meniscus of the lateral compartment were associated with the risk of suffering an ACL injury in females. In part 2, the size of the medial compartment tibial spine was significantly associated with the risk of suffering an ACL injury in males. In part 3, the comprehensive best-fit anatomical risk model included measurements of articular cartilage of the laternal tibial plateau and the of the femoral intercondylar notch morphology for females, and measurements of lateral posterior meniscus and ACL morphology for males.
The comprehensive models for anatomical risk factors of knee morphology were different between males and females. Sex specific screening tools may be developed to identify individuals at an increased risk of suffering an ACL injury. Measurements of articular cartilage and meniscus morphology proved to be more independently associated with risk in contrast to measurements previously described in the literature.