Imageological Evaluation On Knee Joint Injury And It's Reconstructive Structures

Part one: Correlative factor and MRI value of meniscus injuryThe knee joint is a rather complex joint and easy to be injured in variours conditions. As a unigue location and burden structure of the knee, meniscus was frequently injured. It's very important to make correct diagnosis for meniscus because the patient suffered instability, pain, swelling and dysfunction of knee. X-ray cannot show meniscus, opacificationg is a traumatic examine, which not only brings distress to patient but also generate complication. CT also has limited value in meniscus. Magnetic resonance imaging (MRI), with high soft tissue resolution, can display structure and injury of meniscu periphery ligament, muscle and bone.Part Two: Research on relationship between transverse geniculate ligament and meniscus injuryObjective: To investigate the relationship between transverse geniculate ligament and the position & grade of meniscus injury, so as to study the clinical significance of transverse geniculate ligament.Methods: Authors collected 288 cases of knee joints with MRI scan from January 2009 to May 2010 in Peking University Shenzhen Hospital. The presence of transverse geniculate ligaments and the position & grade of injury were observed, and then relationship between them were analysed. Statistical analysis was performed usingχ2 test ,and the difference is significant with P value of <0.05.Results: Transverse geniculate ligaments are presented with a rate of 43.1%(124/288)and mean thickness(2.5±1.5)mm in our MRI examinations. The presence of transverse geniculate ligament is independent with the grade of meniscus injury(P>0.05), but it is relative with the position of meniscus injury(P<0.01).Conclusions: Transverse geniculate ligament which is random appeared structure connecting the anterior horns of both meniscus may protect the anterior horns of meniscus and may contribute to keep stability of the knee joint.Part Three: The MRI value on the injury of anterior curciate ligamentAnterior cruciatie ligament(ACL) is important to keep the stability of knee joint, which often appear a syndrome such as instability, pain, swelling and dysfunction when injured. It's important to diagnose and assess the injury of ACL earlier to arrange a suitable treatment plan and remodel the stability. MRI ,with high soft tissue resolution, can display ACL's shape, structure explicitly and is susceptible to ACL's swelling and torn. As a non-nivasive method ,MRI not only can display direct signs of ACL injury(such as interruption and swelling),but also can display some indirect signs(such as injury of bone, tibia inlocation, effusion of joint). MRI is one of the most effective method in diagnosing a variety trama of ACL. Part Four: Evaluation on double-bundle reconstruction of anterior cruciate ligament with MRI and MSCTObjective To apply MRI and Multi-Slice Computed Tomography (MSCT) on estimating the anatomy feature of reconstructed Anterior Cruciate Ligament (ACL).Methods Twenty-one patients (Twenty-one knees, 6 cases of left side and 15 of right side), 17males and 4 fema1es,aged from 21 to 49 years old, who underwent anterior cruciate ligament double-bundle reconstruction with arthroscope, were included in this study.MRI and MSCT were performed after the operation. We assessed the ACL in MRI and tunnel in MSCT. The length, location on tibial plateau, angle with tibial plateau of anteromedial bundle (AMB) and posterolateral bundle (PLB) were measured. Then the reconstructed ACL data which measured in MRI and MSCT were compared with anatomic data.Results In 21 cases, 11 cases had inhomogeneous signal while the other cases had homogeneous low signal in MRI. We also found enlarged tunnel in 7 cases while the others were non-enlarged. AMB's length, angle with tibial plateau, PLB's angle with tibial plateau measured in MRI and MSCT were compared with anatomic data,but there were no significant difference(P>0.05). PLB's length, distance to posterior border of tibial plateau and ALB's distance to anterior border of tibial plateau measured in MRI and MSCT were compared with homologue anatomic data, where there were showed significant difference(P<0.05).Conclusion MRI and MSCT can explicitly display the shape, anatomic location and tunnel of graft after ACL reconstruction. MRI and MSCT are important method in assessing ACL reconstruction.