A Translational Method to Quantify Anterior Cruciate Ligament Healing Using Magnetic Resonance Imaging for Research and Clinical Applications

Biercevicz, Alison M.

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Year:: 2015
Contributor:: Biercevicz, Alison M (creator); Fleming, Braden (Director); Crisco, Joseph (Reader); Darling, Eric (Reader); Deoni, Sean (Reader); Thornton, Gail (Reader); Brown University. Biomedical Engineering (sponsor)
Genre:: theses
Subject:: Orthopaedics; MRI; Ligament mechanics; T2* relaxometry; Linear Regression Modeling; Reconstruction; Injury; Orthopedics; Anterior cruciate ligament; Knee; Magnetic resonance imaging; Surgery; Biomechanics
Extent:: XXVI, 219 p.
DOI: https://doi.org/10.7301/Z09885CN

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Abstract:: The goal of this thesis was to use non-invasive quantifiable MR parameters of volume, signal intensity and T2* relaxation time to predict the biomechanical or histological outcomes of an ACL graft or ACL repair as a surrogate outcome measure for healing. The main focus of this thesis was on developing imaging methods for determining these MR parameters and evaluating how these parameters could be used to assess ligament or graft healing, in both animal models and in clinical trials. Our first goal was to design an MR imaging method to predict the structural properties of a healing ligament or graft in a large animal model. We found that the linear combination of MR derived volume and SI, as a surrogate for tissue integrity, predicted ex vivo structural properties in a healing ACL or graft. As a further refinement of this approach, it was found partial volumes defined by equal intervals of T2*, predicted structural properties of a healing ligament with the benefit of T2* being an inherent tissue property with potential to be standardized across institutions. In addition to being predictive of gross biomechanical performance, T2* was also found to be predictive of histological outcomes that have been associated with ligament healing on a microscopic level. A complimentary study determined that these same imaging parameters were not significantly associated with biomechanical performance of degenerating ACLs in a human cadaveric population clustered around 50 years of age. Inherent differences with the macro or micro anatomy of the degenerating ligaments may have lead to the insignificant findings. Finally, as a translational step, the combination of volume and SI were found to be predictive of traditional outcomes, such as, the hop test, for patients that received ACL reconstruction. The noninvasive MR methods presented here for predicting the structural properties and histological outcomes of the graft or ligament will allow researchers to document healing longitudinally within a specimen in pre-clinical animal studies. Furthermore, these findings may have implications as a surrogate outcome measure in clinical studies for documenting temporal changes within-patients and as a more quantitative method for guiding rehabilitation.
Notes:: Thesis (Ph.D. -- Brown University (2015)

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Biercevicz, Alison M., "A Translational Method to Quantify Anterior Cruciate Ligament Healing Using Magnetic Resonance Imaging for Research and Clinical Applications" (2015). Biomedical Engineering Theses and Dissertations. Brown Digital Repository. Brown University Library. https://doi.org/10.7301/Z09885CN

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Biomedical Engineering Theses and Dissertations

Theses and Dissertations for the Biomedical Engineering department.
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