Measuring biomechanics of the knee with an acceptable degree of accuracy is difficult. When the in vivo knee joint motion is analyzed in all its six degrees-of-freedom without compromising on... Show moreMeasuring biomechanics of the knee with an acceptable degree of accuracy is difficult. When the in vivo knee joint motion is analyzed in all its six degrees-of-freedom without compromising on physiological loading conditions, the task becomes even more challenging. This thesis offers a brief overview of the development, validation and application of a non-invasive imaging methodology to capture the in vivo biomechanics of anterior cruciate ligament (ACL) deficient and posterior cruciate ligament (PCL) deficient knees. By combining dual fluoroscopy to capture the in vivo joint motion and magnetic resonance imaging to reconstruct the joint anatomy, we obtained a comprehensive insight in both tibiofemoral as well as patellofemoral kinematics and cartilage biomechanics of healthy knees under various loading conditions. These baseline measurements helped us comprehend the alterations in biomechanics seen in knees after injury of either ACL or PCL, which in turn generated clinically useful data for the improvement of our surgical reconstruction techniques. Show less
Osteoarthritis of the knee is a chronic progressive joint disease leading to pain and loss of function in a considerable proportion of patients with great impact and consequences in the ageing... Show moreOsteoarthritis of the knee is a chronic progressive joint disease leading to pain and loss of function in a considerable proportion of patients with great impact and consequences in the ageing population of the industrialized world. Clinical symptoms and radiographs of the knee are normally used to monitor osteoarthritic changes in the knee. However, the correlation between radiographic osteoarthritic findings and clinical features is poor. Does MR imaging of the knee tell us more about the relation between osteoarthritic structural findings and clinical features? According to the present thesis, the answer is “No”. Most of the data presented in this thesis is based on a 1.5T longitudinal MR study called the “Genetica, Artrose & Progressie” (GARP) study. In the GARP study MR imaging findings were associated with clinical features of patients with OA, and it was concluded that there were no strong associations between the most important OA imaging findings and clinical features of patients with OA. These controversial findings are important findings with regards to future clinical trials, as it urges conservatism with regards to the idea of BME being an outcome measure for progression of the disease. Therefore, the current theses also strongly recommend a further quest to identify ideal parameters to quantify the progression of the disease. Show less
