A Novel Measure of in-Vivo Knee Joint Laxity

Current measures of knee joint laxity, such as those found clinically using the KT-2000 arthrometer, are not highly repeatable or reliable (Huber et al, 1997). In this study, a noninvasive in-vivo Magnetic Resonance imaging-based measure of laxity, the Knee Loading Apparatus (KLA), was designed and evaluated with five normal subjects (repeatability study, n=3). Effects of total body water content, hormones, and muscle guarding were considered. When compared to the KT-2000, the KLA was found to be less variable (±0.58 mm vs. ±1.47 mm). Future KLA design iterations should aim to control the initial positioning of the subject, a finding that may shed light on the low reliability of the KT2000. The KLA enabled quantification of both in-vivo knee joint stress relaxation and ACL (ligament specific) laxity for the first time. The KLA shows promise as an accurate and reliable tool for measuring in-vivo joint and ligament laxity, and viscoelastic behavior.

Year	Entry
2001	Provenzano P, Lakes R, Keenan T, Vanderby R Jr. Nonlinear ligament viscoelasticity. Ann Biomed Eng. October 2001;29(10):908-914.
1972	Fung Y-CB. Stress-strain-history relations of soft tissues in simple elongation. In: Fung YC, Perrone N, Anliker M, eds. Biomechanics: Its Foundations and Objectives. Symposium on Biomechanics, its Foundations and Objectives; July 29-31, 1970. Englewood Cliff, NJ: Inc., Prentice-Hall International; 1972:181-208.
2002	Baker SN. In-Vivo Quantification of Patellofemoral Joint Contact Force Using a Mathematical Model [Master's thesis]. Calgary, AB: University of Calgary; January 2002.
1993	Söderkvist I, Wedin P-Å. Determining the movements of the skeleton using well-configured markers. J Biomech. December 1993;26(12):1473-1477.
1982	Woo SL-Y. Mechanical properties of tendons and ligaments, I: quasi-static and nonlinear viscoelastic properties. Biorheology. 1982;19(3):385-396.
1997	Thornton GM, Oliynyk A, Frank CB, Shrive NG. Ligament creep cannot be predicted from stress relaxation at low stress: a biomechanical study of the rabbit medial collateral ligament. J Orthop Res. 1997;15(5):652-656.
1994	Ronsky JL. In-Vivo Quantification of Patellofemoral Joint Contact Characteristics [PhD thesis]. Calgary, AB: University of Calgary; 1994.
1988	Veldpaus FE, Woltring HJ, Dortmans JMG. A least-squares algorithm for the equiform transformation from spatial marker co-ordinates. J Biomech. 1988;21(1):45-54.
1980	Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee: a biomechanical study. J Bone Joint Surg. March 1980;62A(2):259-270.
2006	Connolly KD. In-Vivo Characterization of Patellar Tracking in Normal and PFPS [Master's thesis]. Calgary, AB: University of Calgary; 2006.
2004	Fleming BC, Beynnon BD. In vivo measurement of ligament/tendon strains and forces: a review. Ann Biomed Eng. 2004;32(3):318-328.
2006	Cheng WTR. Registration for the in-Vivo Studies of Osteoarthritis Based on Magnetic Resonance Imaging [Master's thesis]. Calgary, AB: University of Calgary; April 2006.
1995	Challis JH. A procedure for determining rigid body transformation parameters. J Biomech. June 1995;28(6):733-737.
1992	Chimich D, Shrive N, Frank C, Marchuk L, Bray R. Water content alters viscoelastic behaviour of the normal adolescent rabbit medial collateral ligament. J Biomech. August 1992;25(8):831-837.
2001	Thornton GM, Shrive NG, Frank CB. Altering ligament water content affects ligament pre-stress and creep behaviour. J Orthop Res. September 2001;19(5):845-851.
1990	Winter DA. Biomechanics and Motor Control of Human Movement. 2nd ed. New York, NY: Inc., John Wiley & Sons; 1990.
2007	Fjeld IR. In-Vivo Dynamic Joint Stability Quantified in Intact and ACL Deficient Knees [Master's thesis]. Calgary, AB: University of Calgary; 2007.
2007	Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. October 2007;35(10):1756-1769.
2004	Abramowitch SD, Woo SL-Y. An improved method to analyze the stress relaxation of ligaments following a finite ramp time based on the quasi-linear viscoelastic theory. J Biomech Eng. February 2004;126(1):92-97.
1999	Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train. June 1999;34(2):86-92.
2001	Moss RT. Quantification of Patellofemoral Contact Area Using MR Imaging, a Validation and Comparative Study [Master's thesis]. Calgary, AB: University of Calgary; September 2001.
1997	Haut TL, Haut RC. The state of tissue hydration determines the strain-rate-sensitive stiffness of human patellar tendon. J Biomech. January 1997;30(1):79-81.
1997	Huber FE, Irrgang JJ, Harner C, Lephart S. Intratester and intertester reliability of the KT-1000 arthrometer in the assessment of posterior laxity of the knee. Am J Sports Med. July–August 1997;25(5):479-485.

Year

Entry

2001

Provenzano P, Lakes R, Keenan T, Vanderby R Jr. Nonlinear ligament viscoelasticity. Ann Biomed Eng. October 2001;29(10):908-914.

1972

Fung Y-CB. Stress-strain-history relations of soft tissues in simple elongation. In: Fung YC, Perrone N, Anliker M, eds. Biomechanics: Its Foundations and Objectives. Symposium on Biomechanics, its Foundations and Objectives; July 29-31, 1970. Englewood Cliff, NJ: Inc., Prentice-Hall International; 1972:181-208.

2002

Baker SN. In-Vivo Quantification of Patellofemoral Joint Contact Force Using a Mathematical Model [Master's thesis]. Calgary, AB: University of Calgary; January 2002.

1993

Söderkvist I, Wedin P-Å. Determining the movements of the skeleton using well-configured markers. J Biomech. December 1993;26(12):1473-1477.

1982

Woo SL-Y. Mechanical properties of tendons and ligaments, I: quasi-static and nonlinear viscoelastic properties. Biorheology. 1982;19(3):385-396.

1997

Thornton GM, Oliynyk A, Frank CB, Shrive NG. Ligament creep cannot be predicted from stress relaxation at low stress: a biomechanical study of the rabbit medial collateral ligament. J Orthop Res. 1997;15(5):652-656.

1994

Ronsky JL. In-Vivo Quantification of Patellofemoral Joint Contact Characteristics [PhD thesis]. Calgary, AB: University of Calgary; 1994.

1988

Veldpaus FE, Woltring HJ, Dortmans JMG. A least-squares algorithm for the equiform transformation from spatial marker co-ordinates. J Biomech. 1988;21(1):45-54.

1980

Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee: a biomechanical study. J Bone Joint Surg. March 1980;62A(2):259-270.

2006

Connolly KD. In-Vivo Characterization of Patellar Tracking in Normal and PFPS [Master's thesis]. Calgary, AB: University of Calgary; 2006.

2004

Fleming BC, Beynnon BD. In vivo measurement of ligament/tendon strains and forces: a review. Ann Biomed Eng. 2004;32(3):318-328.

2006

Cheng WTR. Registration for the in-Vivo Studies of Osteoarthritis Based on Magnetic Resonance Imaging [Master's thesis]. Calgary, AB: University of Calgary; April 2006.

1995

Challis JH. A procedure for determining rigid body transformation parameters. J Biomech. June 1995;28(6):733-737.

1992

Chimich D, Shrive N, Frank C, Marchuk L, Bray R. Water content alters viscoelastic behaviour of the normal adolescent rabbit medial collateral ligament. J Biomech. August 1992;25(8):831-837.

2001

Thornton GM, Shrive NG, Frank CB. Altering ligament water content affects ligament pre-stress and creep behaviour. J Orthop Res. September 2001;19(5):845-851.

1990

Winter DA. Biomechanics and Motor Control of Human Movement. 2nd ed. New York, NY: Inc., John Wiley & Sons; 1990.

2007

Fjeld IR. In-Vivo Dynamic Joint Stability Quantified in Intact and ACL Deficient Knees [Master's thesis]. Calgary, AB: University of Calgary; 2007.

2007

Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. October 2007;35(10):1756-1769.

2004

Abramowitch SD, Woo SL-Y. An improved method to analyze the stress relaxation of ligaments following a finite ramp time based on the quasi-linear viscoelastic theory. J Biomech Eng. February 2004;126(1):92-97.

1999

Arendt EA, Agel J, Dick R. Anterior cruciate ligament injury patterns among collegiate men and women. J Athl Train. June 1999;34(2):86-92.

2001

Moss RT. Quantification of Patellofemoral Contact Area Using MR Imaging, a Validation and Comparative Study [Master's thesis]. Calgary, AB: University of Calgary; September 2001.

1997

Haut TL, Haut RC. The state of tissue hydration determines the strain-rate-sensitive stiffness of human patellar tendon. J Biomech. January 1997;30(1):79-81.

1997

Huber FE, Irrgang JJ, Harner C, Lephart S. Intratester and intertester reliability of the KT-1000 arthrometer in the assessment of posterior laxity of the knee. Am J Sports Med. July–August 1997;25(5):479-485.

Year	Entry
2011	Westover LM. Quantifying in Vivo Laxity in the ACL and Individual Knee Joint Structures: A Numerical Modeling Approach [Master's thesis]. Calgary, AB: University of Calgary; December 2011.
2015	Bishop EL. Quantifying Temporal Changes in Knee Joint Laxity and Dynamic Knee Stability for Healthy and Acute ACL Injured Individuals [PhD thesis]. Calgary, AB: University of Calgary; January 2015.
2017	Dai X. Characterization of OA Severity in Knee Articular Cartilage in-Vivo Using MR Imaging and Loading Techniques [PhD thesis]. Calgary, AB: University of Calgary; August 2017.

Year

Entry

2011

Westover LM. Quantifying in Vivo Laxity in the ACL and Individual Knee Joint Structures: A Numerical Modeling Approach [Master's thesis]. Calgary, AB: University of Calgary; December 2011.

2015

Bishop EL. Quantifying Temporal Changes in Knee Joint Laxity and Dynamic Knee Stability for Healthy and Acute ACL Injured Individuals [PhD thesis]. Calgary, AB: University of Calgary; January 2015.

2017

Dai X. Characterization of OA Severity in Knee Articular Cartilage in-Vivo Using MR Imaging and Loading Techniques [PhD thesis]. Calgary, AB: University of Calgary; August 2017.