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Zinno R, Alesi D, Di Paolo S, Pizza N, Zaffagnini S, Marcheggiani Muccioli GM, Bragonzoni L. Wider translations and rotations in posterior-stabilised mobile-bearing total knee arthroplasty compared to fixed-bearing both implanted with mechanical alignment: a dynamic RSA study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4969-4976. [PMID: 37615718 PMCID: PMC10598183 DOI: 10.1007/s00167-023-07541-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/04/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The purpose of this study was to investigate the in vivo kinematics of the same femoral design mechanically aligned posterior-stabilised (PS) total knee arthroplasty (TKA) with either fixed-bearing (FB) or mobile-bearing (MB) inlay, implanted by the same surgeon, using model-based dynamic radiostereometric analysis (RSA). The hypothesis of the present study was that the MB design would show wider axial rotation than the FB design, without affecting the clinical outcomes. MATERIALS AND METHODS A cohort of 21 non-randomised patients (21 DePuy Attune PS-FB) was evaluated by dynamic RSA analysis at a minimum 9-month follow-up, while performing differently demanding daily living activities such as sit to stand (STS) and deep knee lunge (DKL). Kinematic data were compared with those of a cohort of 22 patients implanted with the same prosthetic design but with MB inlay. Anterior-posterior (AP) translations, varus-valgus (VV) and internal-external (IE) rotations of the femoral component with respect to the tibial baseplate were investigated. Translation of medial and lateral compartment was analysed using the low point method according to Freeman et al. Questionnaires to calculate objective and subjective clinical scores were administered preoperatively and during follow-up visit by the same investigator. RESULTS The FB TKA design showed lower AP translation during STS (6.8 ± 3.3 mm in FB vs 9.9 ± 3.7 mm in MB, p = 0.006*), lower VV rotation (1.9 ± 0.8° in FB vs 5.3 ± 3.3° in MB, p = 0.005) and lower IE rotation (2.8 ± 1.1° in FB vs 9.5 ± 4.3° in MB, p = 0.001) during DKL than the mobile-bearing TKA design. Posterior-stabilised FB group showed significant lower translation of the low point of the medial compartment than the MB group (p = 0.008). The percentage of patients performing medial pivot in the FB group was higher compared to MB group in the examined motor tasks. No significant differences in post-operative range of motion (117° ± 16° for FB group and 124° ± 13° for MB group) and in clinical outcomes emerged between the two cohort. CONCLUSIONS The FB and MB designs differed in AP translations, VV rotations and IE rotations of the femoral component with respect to the tibial component in STS and DKL. Furthermore, FB cohort reported a significant higher percentage of medial pivot with respect to MB cohort. Despite this, no differences in clinical outcomes were detected between groups. Both designs showed stable kinematics and represent a viable option in primary TKA. LEVEL OF EVIDENCE Prospective cohort study, II.
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Affiliation(s)
- Raffaele Zinno
- Dipartimento Di Scienze Per La Qualità Della Vita QUVI, University of Bologna, Corso D’Augusto 237, 47921 Rimini, RN Italy
| | - Domenico Alesi
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, BO Italy
- Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, University of Bologna, Via San Vitale, 40125 Bologna, BO Italy
| | - Stefano Di Paolo
- Dipartimento Di Scienze Per La Qualità Della Vita QUVI, University of Bologna, Corso D’Augusto 237, 47921 Rimini, RN Italy
| | - Nicola Pizza
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, BO Italy
| | - Stefano Zaffagnini
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, BO Italy
- Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, University of Bologna, Via San Vitale, 40125 Bologna, BO Italy
| | - Giulio Maria Marcheggiani Muccioli
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136 Bologna, BO Italy
- Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, University of Bologna, Via San Vitale, 40125 Bologna, BO Italy
| | - Laura Bragonzoni
- Dipartimento Di Scienze Per La Qualità Della Vita QUVI, University of Bologna, Corso D’Augusto 237, 47921 Rimini, RN Italy
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In vivo kinematic comparison between an ultra-congruent and a posterior-stabilized total knee arthroplasty design by RSA. Knee Surg Sports Traumatol Arthrosc 2022; 30:2753-2758. [PMID: 34117894 DOI: 10.1007/s00167-021-06629-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE The aim of the present study was to compare the in vivo under weight-bearing kinematic behavior of a posterior-stabilized (PS) and an ultra-congruent (UC) total knee arthroplasty (TKA) model during a sit-to-stand motor task, a common activity of daily life. METHODS A cohort of 16 randomly selected patients (8 PS Persona Zimmer, 8 UC Persona Zimmer) was evaluated through dynamic radiostereometric analysis (RSA) at a minimum of 9 months after TKA, during the execution of a sit-to-stand. The anteroposterior (AP) translation of the femoral component and the AP translation of the low point of medial and lateral femoral compartments were compared through Student's t test (p < 0.05). RESULTS A significantly greater anterior translation of the femoral component was found for the PS group compared to the UC group. The flexion interval where statistical significance was found was between 30° and 0° (p = 0.017). Both groups showed a significantly greater anterior translation of the low point of the lateral compartment with respect to the medial one (PS: p = 0.012, UC: p = 0.018). This was consistent with a medial-pivot pattern. Furthermore, a significantly greater anterior translation of the medial compartment was found in the PS group compared to the UC group (p = 0.001). The same pattern was observed for the lateral compartment (p = 0.006). CONCLUSIONS The TKA designs evaluated in the present study showed comparable in-vivo kinematics with regards to medial pivot pattern but differences in absolute AP translation. Specifically, the UC design showed greater AP stability than the PS design. This finding could be positive in terms of implant stability, but negative in terms of premature polyethylene wear and thus implant failure. This remains to be verified in studies with a larger sample size and longer follow-up. LEVEL OF EVIDENCE IV.
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Pizza N, Di Paolo S, Zinno R, Marcheggiani Muccioli GM, Agostinone P, Alesi D, Bontempi M, Zaffagnini S, Bragonzoni L. Over-constrained kinematic of the medial compartment leads to lower clinical outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2022; 30:661-667. [PMID: 33386880 PMCID: PMC8866343 DOI: 10.1007/s00167-020-06398-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/24/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate if postoperative clinical outcomes correlate with specific kinematic patterns after total knee arthroplasty (TKA) surgery. The hypothesis was that the group of patients with higher clinical outcomes would have shown postoperative medial pivot kinematics, while the group of patients with lower clinical outcomes would have not. METHODS 52 patients undergoing TKA surgery were prospectively evaluated at least a year of follow-up (13.5 ± 6.8 months) through clinical and functional Knee Society Score (KSS), and kinematically through dynamic radiostereometric analysis (RSA) during a sit-to-stand motor task. Patients received posterior-stabilized TKA design. Based on the result of the KSS, patients were divided into two groups: "KSS > 70 group", patients with a good-to-excellent score (93.1 ± 6.8 points, n = 44); "KSS < 70 group", patients with a fair-to-poor score (53.3 ± 18.3 points, n = 8). The anteroposterior (AP) low point (lowest femorotibial contact points) translation of medial and lateral femoral compartments was compared through Student's t test (p < 0.05). RESULTS Low point AP translation of the medial compartment was significantly lower (p < 0.05) than the lateral one in both the KSS > 70 (6.1 mm ± 4.4 mm vs 10.7 mm ± 4.6 mm) and the KSS < 70 groups (2.7 mm ± 3.5 mm vs 11.0 mm ± 5.6 mm). Furthermore, the AP translation of the lateral femoral compartment was not significantly different (p > 0.05) between the two groups, while the AP translation of the medial femoral compartment was significantly higher for the KSS > 70 group (p = 0.0442). CONCLUSION In the group of patients with a postoperative KSS < 70, the medial compartment translation was almost one-fourth of the lateral one. Surgeons should be aware that an over-constrained kinematic of the medial compartment might lead to lower clinical outcomes. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Nicola Pizza
- grid.419038.70000 0001 2154 6641Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, BO Italy
| | - Stefano Di Paolo
- Dipartimento Di Scienze Biomediche E Neuromotorie DIBINEM, Università Di Bologna, Via San Vitale, 40125, Bologna, BO, Italy.
| | - Raffaele Zinno
- grid.6292.f0000 0004 1757 1758Dipartimento Di Scienze Biomediche E Neuromotorie DIBINEM, Università Di Bologna, Via San Vitale, 40125 Bologna, BO Italy
| | - Giulio Maria Marcheggiani Muccioli
- grid.419038.70000 0001 2154 6641Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, BO Italy
| | - Piero Agostinone
- grid.419038.70000 0001 2154 6641Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, BO Italy
| | - Domenico Alesi
- grid.419038.70000 0001 2154 6641Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, BO Italy
| | - Marco Bontempi
- grid.419038.70000 0001 2154 6641Laboratorio Di Biomeccanica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136 Bologna, BO Italy
| | - Stefano Zaffagnini
- grid.419038.70000 0001 2154 6641Clinica Ortopedica E Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, BO Italy ,grid.6292.f0000 0004 1757 1758Dipartimento Di Scienze Biomediche E Neuromotorie DIBINEM, Università Di Bologna, Via San Vitale, 40125 Bologna, BO Italy
| | - Laura Bragonzoni
- grid.6292.f0000 0004 1757 1758QUVI, Università Di Bologna, Corso D’Augusto 237, 47921 Rimini, RN Italy
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Mirulla AI, Bragonzoni L, Zaffagnini S, Ingrassia T, Zinno R, Innocenti B. Assessment of paradoxical anterior translation in a CR total knee prosthesis coupling dynamic RSA and FE techniques. J Exp Orthop 2021; 8:50. [PMID: 34245384 PMCID: PMC8272767 DOI: 10.1186/s40634-021-00361-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose The study aims were to assess the kinematic data, Internal-External (IE) rotation, and Antero-Posterior (AP) translation of the contact points between the femoral condyles and polyethylene insert and to develop a combined dynamic RSA-FE (Radiostereometric – Finite Element) model that gives results congruent with the literature. Methods A cohort of 15 patients who underwent cemented cruciate-retaining highly congruent mobile-bearing total knee arthroplasty were analyzed during a sit-to-stand motor task. The kinematical data from Dynamic RSA were used as input for a patient-specific FE model to calculate condylar contact points between the femoral component and polyethylene insert. Results The femoral component showed an overall range about 4 mm of AP translation during the whole motor task, and the majority of the movement was after 40° of flexion. Concerning the IE rotation, the femoral component started from an externally rotate position (− 6.7 ± 10°) at 80° of flexion and performed an internal rotation during the entire motor task. The overall range of the IE rotation was 8.2°. Conclusions During the sit to stand, a slight anterior translation from 40° to 0° of flexion of the femoral component with respect to polyethylene insert, which could represent a paradoxical anterior translation. Despite a paradoxical anterior femoral translation was detected, the implants were found to be stable. Dynamic RSA and FE combined technique could provide information about prosthetic component’s stress and strain distribution and the influence of the different designs during the movement.
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Affiliation(s)
- Agostino Igor Mirulla
- Department of Engineering, University of Palermo, Palermo, Italy.,Department of Biomedical and Neuromotor Sciencies, Università di Bologna, Bologna, BO, Italy
| | - Laura Bragonzoni
- Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - Stefano Zaffagnini
- Department of Biomedical and Neuromotor Sciencies, Università di Bologna, Bologna, BO, Italy.,2nd Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Raffaele Zinno
- Department for Life Quality Studies, University of Bologna, Rimini, Italy.
| | - Bernardo Innocenti
- BEAMS Department (Bio Electro and Mechanical Systems), Université Libre de Bruxelles, Bruxelles, Belgium
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Alesi D, Marcheggiani Muccioli GM, Roberti di Sarsina T, Bontempi M, Pizza N, Zinno R, Di Paolo S, Zaffagnini S, Bragonzoni L. In vivo femorotibial kinematics of medial-stabilized total knee arthroplasty correlates to post-operative clinical outcomes. Knee Surg Sports Traumatol Arthrosc 2021; 29:491-497. [PMID: 32253483 DOI: 10.1007/s00167-020-05975-w] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/30/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate if there was a correlation between in vivo kinematics of a medial-stabilized (MS) total knee arthroplasty (TKA) and post-operative clinical scores. We hypothesized that (1) a MS-TKA would produce a medial pivot movement and that (2) this specific pattern would be correlated with higher clinical scores. METHODS 18 patients were evaluated through clinical and functional scores evaluation (Knee Society Score clinical and functional, Womac, Oxford), and kinematically through dynamic radiostereometric analysis (RSA) at 9 months after MS-TKA, during the execution of a sit-to-stand and a lunge motor task. The anteroposterior (AP) Low Point translation of medial and lateral femoral compartments was compared through Student's t test (p < 0.05). A correlation analysis between scores and kinematics was performed through the Pearson's correlation coefficient r. RESULTS A significantly greater (p < 0.0001) anterior translation of the lateral compartment with respect to the medial one was found in both sit-to-stand (medial 2.9 mm ± 0.7 mm, lateral 7.1 mm ± 0.6 mm) and lunge (medial 5.3 mm ± 0.9 mm, lateral 10.9 mm ± 0.7 mm) motor tasks, thus resulting in a medial pivot pattern in about 70% of patients. Significant positive correlation in sit-to-stand was found between the peak of AP translation in the lateral compartment and clinical scores (r = 0.59 for Knee Society Score clinical and r = 0.61 for Oxford). Moreover, we found that the higher peak of AP translation of the medial compartment correlated with lower clinical scores (r = - 0.55 for Knee Society Score clinical, r = - 0.61 for Womac and r = - 0.53 for Oxford) in the lunge. A negative correlation was found between Knee Society Score clinical and VV laxity during sit-to-stand (r = - 0.56) and peak of external rotation in the lunge motor task (r = - 0.66). CONCLUSIONS The MS-TKA investigated produced in vivo a medial pivot movement in about 70% of patients in both examined motor tasks. There was a correlation between the presence of medial pivot and higher post-operative scores. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Domenico Alesi
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy
| | - Giulio Maria Marcheggiani Muccioli
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy. .,University of Bologna, Bologna, Italy.
| | - Tommaso Roberti di Sarsina
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy
| | - Marco Bontempi
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy
| | - Nicola Pizza
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy
| | - Raffaele Zinno
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy
| | - Stefano Di Paolo
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy
| | - Stefano Zaffagnini
- 2nd Orthopaedic and Traumatologic Clinic, IRCCS, Istituto Ortopedico Rizzoli, Via G.B. Pupilli 1, 40136, Bologna, Italy.,University of Bologna, Bologna, Italy
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Watanabe S, Tomita T, Akagi R, Watanabe A, Yamazaki T, Enomoto T, Nakagawa R, Kimura S, Ohtori S, Sasho T. In vivo kinematics of cruciate-retaining total knee arthroplasty after a change of polyethylene insert configuration. ASIA-PACIFIC JOURNAL OF SPORT MEDICINE ARTHROSCOPY REHABILITATION AND TECHNOLOGY 2020; 24:1-8. [PMID: 33457208 PMCID: PMC7782324 DOI: 10.1016/j.asmart.2020.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/26/2020] [Indexed: 11/30/2022]
Abstract
Background To investigate in vivo kinematics of total knee arthroplasty (TKA) with the introduction of a mildly constrained (MC) type of polyethylene (PE). We compared the knee kinematics with a reported pattern after surgery using the same component with a conventionally constrained (CC) type of PE. Methods Finite element analysis (FEA) was performed to examine different peak stress distribution of both types of PE. For in vivo study, patients who underwent cruciate-retaining TKA using a total knee system with MC-PE were included. Fluoroscopic surveillance was used to measure the weight-bearing deep knee bend (squatting) using a two-dimensional/three-dimensional (2-D/3-D) registration technique. Results FEA analysis revealed the edge loading of the femoral component on PE in CC but not in MC. During the study period, 42 patients underwent TKA with MC-PE. Among them, 13 agreed to participate in the present study. In vivo kinematics analysis found that starting from an average external rotation of femur being 7.1° at 0° of flexion, the rotation slightly decreased to 6.8° at 10° of flexion, then increased with increasing knee flexion until it reached 10.8° at 80° of flexion, and finally decreased to 9.8° at 100° of knee flexion. The results indicate a modest medial pivot pattern. Although the overall pattern was similar for both MC-PE and CC-PE, a slight difference was observed. MC-PE showed a slight internal rotation of 0.3° from 0 to 10° of knee flexion, whereas CC-PE showed a gradual increase of external rotation in this range. Conclusions Change of configuration from CC to MC did not substantially affect in vivo kinematics of knees after TKA. Considering the theoretical wider range of allowance of rotation, MC-PE is easier for knee surgeons to use.
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Affiliation(s)
- Shotaro Watanabe
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan
| | - Tetsuya Tomita
- Department of Orthopedic Biomaterial Science, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan
| | - Atsuya Watanabe
- Department of Orthopaedic Surgery, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba, 283-8686, Japan
| | - Takaharu Yamazaki
- Department of Information Systems, Saitama Institute of Technology, 1690 Fusaiji, Fukaya, Saitama, 369-0293, Japan
| | - Takahiro Enomoto
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan
| | - Ryosuke Nakagawa
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan
| | - Seiji Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan
| | - Seiji Ohtori
- Department of Orthopedic Biomaterial Science, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Takahisa Sasho
- Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan
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Grassi A, Agostinone P, Di Paolo S, Zaffagnini S. Letter to the Editor on "Prediction of Knee Kinematics at Time of Noncontact Anterior Cruciate Ligament Injuries Based on Bone Bruises". Ann Biomed Eng 2020; 49:1-3. [PMID: 32691263 PMCID: PMC7370628 DOI: 10.1007/s10439-020-02574-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 07/15/2020] [Indexed: 01/13/2023]
Abstract
The aim of the present Letter was to comment on the paper “Prediction of Knee Kinematics at Time of Noncontact Anterior Cruciate Ligament Injuries Based on Bone Bruises” from Shi et al. (Ann Biomed Eng, 2020, 10.1007/s10439-020-02523-y). Though the authors provided an extremely interesting paper on a debated topic in Sport Medicine, with a strong methodology and consistent results, caution should be used when drawing conclusions on Anterior Cruciate Ligament injury mechanism through the interpretation of such data.
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Affiliation(s)
- Alberto Grassi
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Piero Agostinone
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Stefano Di Paolo
- Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna, Via Giulio Cesare Pupilli, 1, 40136, Bologna, BO, Italy.
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie DIBINEM, Università di Bologna, Via Giulio Cesare Pupilli, 1, 40136, Bologna, BO, Italy
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