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http://dx.doi.org/10.13104/imri.2021.25.2.93

Bone Microarchitecture at the Femoral Attachment of the Posterior Cruciate Ligament (PCL) by Texture Analysis of Magnetic Resonance Imaging (MRI) in Patients with PCL Injury: an Indirect Reflection of Ligament Integrity  

Kim, Hwan (Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine)
Shin, YiRang (Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine)
Kim, Sung-Hwan (Department of Orthopaedic Surgery, Yonsei University College of Medicine)
Lee, Young Han (Department of Radiology, Research Institute of Radiological Science, Medical Convergence Research Institute, and Severance Biomedical Science Institute, Yonsei University College of Medicine)
Publication Information
Investigative Magnetic Resonance Imaging / v.25, no.2, 2021 , pp. 93-100 More about this Journal
Abstract
Purpose: (1) To evaluate the trabecular pattern at the femoral attachment of the posterior cruciate ligament (PCL) in patients with a PCL injury; (2) to analyze bone microarchitecture by applying gray level co-occurrence matrix (GLCM)-based texture analysis; and (3) to determine if there is a significant relationship between bone microarchitecture and posterior instability. Materials and Methods: The study included 96 patients with PCL tears. Trabecular patterns were evaluated on T2-weighted MRI qualitatively, and were evaluated by GLCM texture analysis quantitatively. The grades of posterior drawer test (PDT) and the degrees of posterior displacement on stress radiographs were recorded. The 96 patients were classified into two groups: acute and chronic injury. And 27 patients with no PCL injury were enrolled for control. Pearson's correlation coefficient and one-way ANOVA with Bonferroni test were conducted for statistical analyses. This protocol was approved by the Institutional Review Board. Results: A thick and anisotropic trabecular bone pattern was apparent in normal or acute injury (n = 57/61;93.4%), but was not prominent in chronic injury and posterior instability (n = 31/35;88.6%). Grades of PDT and degrees of posterior displacement on stress radiograph were not correlated with texture parameters. However, the texture analysis parameters of chronic injury were significantly different from those of acute injury and control groups (P < 0.05). Conclusion: The trabecular pattern and texture analysis parameters are useful in predicting posterior instability in patients with PCL injury. Evaluation of the bone microarchitecture resulting from altered biomechanics could advance the understanding of PCL function and improve the detection of PCL injury.
Keywords
Magnetic resonance imaging; Knee; Ligament;
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1 Herlidou S, Grebe R, Grados F, Leuyer N, Fardellone P, Meyer ME. Influence of age and osteoporosis on calcaneus trabecular bone structure: a preliminary in vivo MRI study by quantitative texture analysis. Magn Reson Imaging 2004;22:237-243   DOI
2 Wolff J. Das Gesetz der Transformation der Knochen (Translated as The Law of Bone Remodeling). Berlin, Germany: Verlag von August Hirschwald, 1892
3 Tewes DP, Fritts HM, Fields RD, Quick DC, Buss DD. Chronically injured posterior cruciate ligament: magnetic resonance imaging. Clin Orthop Relat Res 1997;224-232
4 Frost HM. Wolff's Law and bone's structural adaptations to mechanical usage: an overview for clinicians. Angle Orthod 1994;64:175-188
5 Seeman E, Delmas PD. Bone quality--the material and structural basis of bone strength and fragility. N Engl J Med 2006;354:2250-2261   DOI
6 Hollister SJ, Brennan JM, Kikuchi N. A homogenization sampling procedure for calculating trabecular bone effective stiffness and tissue level stress. J Biomech 1994;27:433-444   DOI
7 Liu XS, Sajda P, Saha PK, et al. Complete volumetric decomposition of individual trabecular plates and rods and its morphological correlations with anisotropic elastic moduli in human trabecular bone. J Bone Miner Res 2008;23:223-235   DOI
8 Mehlman CT, Araghi A, Roy DR. Hyphenated history: the Hueter-Volkmann law. Am J Orthop (Belle Mead NJ) 1997;26:798-800
9 Harrison LC, Nikander R, Sikio M, et al. MRI texture analysis of femoral neck: Detection of exercise load-associated differences in trabecular bone. J Magn Reson Imaging 2011;34:1359-1366   DOI
10 Haralick RM, Shanmugam K, Dinstein IH. Textural features for image classification. IEEE Trans Syst Man Cybern B Cybern 1973;610-621
11 Wolf JH. Julis Wolff and his "law of bone remodeling". Orthopade 1995;24:378-386
12 Orakzai SH, Egan CM, Eustace S, Kenny P, O'Flanagan S J, Keogh P. Correlation of intra-articular osseous measurements with posterior cruciate ligament length on MRI scans. Br J Radiol 2010;83:23-27   DOI
13 Grover JS, Bassett LW, Gross ML, Seeger LL, Finerman GA. Posterior cruciate ligament: MR imaging. Radiology 1990;174:527-530   DOI
14 Weinans H, Huiskes R, Grootenboer HJ. The behavior of adaptive bone-remodeling simulation models. J Biomech 1992;25:1425-1441   DOI
15 Fontbote CA, Sell TC, Laudner KG, et al. Neuromuscular and biomechanical adaptations of patients with isolated deficiency of the posterior cruciate ligament. Am J Sports Med 2005;33:982-989   DOI
16 Shelbourne KD, Davis TJ, Patel DV. The natural history of acute, isolated, nonoperatively treated posterior cruciate ligament injuries. A prospective study. Am J Sports Med 1999;27:276-283   DOI