title: Fluoroscopic Analysis of Tibial Translation in Anterior Cruciate Ligament Injured Knees With and Without Bracing During Forward Lunge.
abstract: BACKGROUND
  Despite several studies with different methods, the effect of functional knee braces on knee joint kinematics is not clear. Direct visualization of joint components through medical imaging modalities may provide the clinicians with more useful information.
  
  
  OBJECTIVE
  In this study, for the first time in the literature, video fluoroscopy was used to investigate the effect of knee bracing on the sagittal plane kinematics of anterior cruciate ligament (ACL) injured patients.
  
  
  METHODS
  For twelve male unilateral ACL deficient subjects, the anterior tibial translation was measured during lunge exercise in non-braced and braced conditions. Fluoroscopic images were acquired from the subjects using a digital fluoroscopy system with a rate of 10 fps. The image of each frame was scaled using a calibration coin and analyzed in AutoCAD environment. The angle between the two lines, tangent to the posterior cortexes of the femoral and tibial shafts was measured as the flexion angle. For the fluoroscopic images associated with 0°, 15°, 30°, 45° and 60° knee flexion angles, the relative anterior-posterior configuration of the tibiofemoral joint was assessed by measuring the position of landmarks on the tibia and femur.
  
  
  RESULTS
  Results indicated that the overall anterior translations of the tibia during the eccentric (down) and concentric (up) phases of lunge exercise were 10.4 ± 1.7 mm and 9.0 ± 2.2 mm for non-braced, and 10.1 ± 3.4 mm and 7.4 ± 2.5 mm, for braced conditions, respectively. The difference of the tibial anterior-posterior translation behaviors of the braced and non-braced knees was not statistically significant.
  
  
  CONCLUSIONS
  Fluoroscopic imaging provides an effective tool to measure the dynamic behavior of the knee joint in the sagittal plane and within the limitations of this study, the pure mechanical stabilizing effect of functional knee bracing is not sufficient to control the anterior tibial translation of the ACL deficient patients during lunge exercise.
authors.affiliation: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran ; Iran Helal Institute of Applied Sciences and Technology, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Jalali
authors.affiliation: University of Leeds, Leeds, UK ; Research Center of Biomedical Technologies and Robotics (RCBTR), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farzam
authors.initials: F
authors.lastname: Farahmand
authors.affiliation: Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Seyed Mohammad Ebrahim
authors.initials: SM
authors.lastname: Mousavi
authors.affiliation: Department of Radiology, Mostafa Khomeini Hospital, Shahed University, Tehran, Iran.
authors.forename: Seyed Ali
authors.initials: SA
authors.lastname: Golestanha
authors.affiliation: University of Leeds, Leeds, UK.
authors.forename: Tahmineh
authors.initials: T
authors.lastname: Rezaeian
authors.affiliation: Sports Medicine Federation, Tehran, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Shirvani Broujeni
authors.affiliation: Department of Biostatistics and Computer, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Rahgozar
authors.affiliation: Department of Physical Therapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Fateme
authors.initials: F
authors.lastname: Esfandiarpour
keywords: Anterior Cruciate Ligament; Brace; Fluoroscopy; Kinematics; Knee Joint