Anterior Cruciate Ligament Rupture
Conditions
Keywords
arthrogenic muscle inhibition, anterior cruciate ligament, functional brain MRI, Central nervous system, Knee trauma
Brief summary
Arthrogenic Muscle Inhibition (AMI) is one of the classic complications occurring in the aftermath of knee trauma; AMI is grossly defined as a lack of extension due to quadriceps inhibition and hamstring contracture. However, its origins remains unknown with a strong suspicion for a central brain origin. It could be the missing link explaining this lack of extension following an anterior cruciate ligament (ACL) rupture. The primary hypothesis of this study is that a difference in activation of motor brain areas exists in patients with an ACL rupture, between those with AMI or without. The second hypothesis is that this difference could be seen on brain functional MRI.
Detailed description
AMI leads to quadriceps atrophy, persistent knee pain, dynamic instability, and a higher rate of osteoarthritis. A recent literature review suggests that the AMI phenomenon is multifactorial, but not widely known and poorly understood. Known mechanisms include impaired motor function at rest, impaired transmission of information from joint sensory receptors, impaired excitability of the spinal reflex and impaired cortical activity. Several studies have suggested a link between ACL rupture and central nervous system reorganization. Among the neurophysiological investigations explored are the evoked somesthesic potentials, electroencephalography, and transcranial magnetic stimulation (TMS). However, these mechanisms alone do not explain the phenomenon in its entirety, suggesting that there are other mechanisms. Furthermore, no study has used functional brain MRI to assess the existence of similar changes in AMI. This study plans to compare two groups of patients with an ACL rupture: a group with AMI, and a group without AMI. Both groups will undergo a functional brain MRI in order to analyse any modification of the sensory-motor network connectivity that could occur.
Interventions
DIAGNOSTIC_TESTfunctional brain MRI
The functional brain MRI realized will be a examination with a resting sequence and a sequence during a movement imagination task. (knee bent)
Sponsors
University Hospital, Toulouse
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
prospective, monocentric, interventional, comparative, controlled, non-randomized study
Eligibility
Sex/Gender
MALE
Age
20 Years to 30 Years
Healthy volunteers
No
Inclusion criteria
* male patient, right-handed, * with a severe right knee sprain in the event of ACL rupture, * occurrence of trauma within 4 weeks prior to inclusion, * with a score of ≥ 8/10 on the Edinburgh Manual Laterality Questionnaire, -affiliated or benefiting from public health services.
Exclusion criteria
* person presenting any of these conditions : professional player / athlete, -contraindication to the MRI examination (claustrophobic patient, patient with a metallic element), * patient already operated on with ligament damage to the knee other than ACL, * patient with iterative ACL rupture, * patient who has undergone contralateral ligament reconstruction, * patient with multi-ligamentary knee injury, * patient refusing to be informed of any abnormality detected on brain MRI, -protected patient (adults under guardianship or other legal protection, deprived of their liberty by judicial or administrative decision).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Matrix of correlation coefficients | Day 0 | A matrix of correlation coefficients, measured by MRI, representing the strength of the sensory-motor network connectivity at rest for each group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Activation map of the motor representations of knee movement | Day 0 | An activation map of the motor representations of knee movement are measured by MRI |
Countries
France
Outcome results
None listed